Abstract:

Accessory cavitated uterine malformations (ACUM) is a rare developmental Müllerian duct malformation with clinical manifestations mainly dysmenorrhea or chronic pelvic pain, which is cured by surgical resection of the malformed mass, such as laparoscopy or open surgery, after the diagnosis is clear. We report a case of a young woman with progressive worsening of dysmenorrhea for more than 3 years, requiring oral painkillers for relief. Gynecological ultrasound showed that an equal echogenic nodule was detected in the left wall of the uterus with a size of 36 mm×35 mm×33 mm, which was seen to resemble endometrial echoes with a thickness of 11 mm, and a suspicious residual angel of the uterus. After laparoscopic exploration, the uterus was normal in size, and a cystic adenomyoma-like nodule with a diameter of 4 cm was seen below the attachment of the left round ligament, and the development of bilateral fallopian tubes and ovaries was normal; after complete removal of the myoma-like mass, a small amount of endometrial tissue and old blood were seen in the incised myometrial wall, and the pathology of the disease confirmed the diagnosis of ACUM, and the symptoms disappeared in the postoperative follow-up. Clinical awareness of this disease should be strengthened, and focus on multiple ultrasound results for comparative analysis, for early diagnosis and timely treatment.

Key words: Accessory cavitated uterine malformations, Dysmenorrhea, Pelvic pain, Diagnosis, Prognosis