Abstract:

Accessory cavitated uterine malformation (ACUM) is a rare obstructive organ malformation, often found in young women, with the main clinical manifestations of progressively aggravated dysmenorrhea and recurrent pelvic pain. It should be differentiated from cystic adenomyopathy, congenital uterine cyst and residual horn uterus. At present, surgery is the most effective treatment. We report a married female patient with dysmenorrhea for 4 years, paroxysmal lower abdominal pain radiating to the perineum and back, progressively aggravated, requiring oral painkillers. In August 2023, gynecological vaginal ultrasound showed that the right side of the uterus was about 3.5 cm×2.7 cm heterogeneity nodular echo, the visible range was about 1.1 cm×0.6 cm small echoless area, the nature of which was to be determined. Laparoscopic exploration was performed. The uterus was normal in size, centered, and rosy. The appearance of bilateral fallopian tubes and ovaries was normal. On the right side of the uterus near the uterine horn, there was a slightly outward protrusion between the fallopian tube and the right round ligament. A hard muscular mass of about 3 cm in diameter was exfoliated from the protrusion. After incision, a space was found with dark-red fluid flowing out. The tumor was completely resected for examination and the diagnosis was confirmed as ACUM by pathological analysis. The symptoms disappeared in the post-operative follow up.

Key words: Accessory cavitated uterine malformation, Dysmenorrhea, Ultrasonography, Magnetic resonance imaging, Case reports