Case Report
PelvicPainandAdnexalMass:BeAwareofAccessoryand
CavitatedUterineMass
PooyaIranpour ,
1
SaraHaseli ,
1,2
PedramKeshavarz ,
3
AmirrezaDehghanian ,
4
andNedaKhalili
5
1
Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD),
Shahid Beheshti University of Medical Sciences, Tehran, Iran
3
Department of Diagnostic & Interventional Radiology of New Hospitals LTD, Tbilisi, Georgia
4
Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
5
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Correspondence should be addressed to Sara Haseli; sarahaseli@gmail.com
Received 24 November 2020; Revised 19 January 2021; Accepted 30 January 2021; Published 11 February 2021
Academic Editor: Michael S. Firstenberg
Copyright © 2021 Pooya Iranpour et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Accessory and cavitated uterine mass (ACUM) is a rare form of Mullerian anomaly that usually presents in young females with
chronic cyclic pelvic pain and/or dysmenorrhea. is clinical entity is often underdiagnosed as it may be mistaken for other
differential diagnoses, such as pedunculated myoma or adnexal lesions. Imaging modalities, including ultrasonography and
magnetic resonance imaging (MRI), accompanied with relevant and suspicious clinical findings are important tools in making
acorrect diagnosis. To date, surgical excision of the mass remains the mainstay of treatment,which provides significant symptom
relief. In this study, we present a female adolescent with chronic pelvic pain since menarche who underwent laparotomy with the
presumed diagnosis of a left-sided ovarian mass. Retrospective evaluation of pelvic MR images demonstrated that the lesion was in
fact an ACUM, which was further confirmed by histopathological examination.
1.Introduction
Accessory and cavitated uterine mass (ACUM) is a rare
newly described Mullerian anomaly, which generally pres-
ents with chronic recurrent pelvic pain and/or severe dys-
menorrhea in women younger than 30 years of age [1]. It is
an accessory mass at the insertion of the round ligament that
is lined by normal endometrium and has a dark-brown-
colored fluid content [2, 3]. ACUMs are difficult to diagnose
because of their broad differential diagnosis, which includes
rudimentary and cavitated uterine horns such as those found
in other uterine malformations (e.g., bicornuate uterus),
adenomyosis with cystic or degenerated areas, degenerated
leiomyomas, and essential and primary dysmenorrhea [4].
To the best of our knowledge, fewer than 60 cases of ACUM
are reported in the literature at the time of writing this paper.
In this case report, we describe a 14-year-old girl presenting
with severe pelvic pain since her menarche. Pelvic magnetic
resonance imaging (MRI) showed an apparent adnexal mass,
but final histopathological examination was in favor of
ACUM.
2.CasePresentation
A 14-year-old girl presented with chronic recurrent pelvic
pain since her menarche. Her pain aggravated monthly
during her menstruation; however, she had a regular and
normal menstrual flow. Her personal history and family
history were not significant, and she had no previous sexual
history. Different kinds of anti-inflammatory medications
had been prescribed for her during the past two years. e
patient had also received oral contraceptive pills (OCPs) for
two months, but none of the medications had been sig-
nificantly effective. On physical examination, she was a
Hindawi
Case Reports in Medicine
Volume 2021, Article ID 6649663, 6 pages
https://doi.org/10.1155/2021/6649663