{"paper_id":"a16345cb-1106-4f1a-b89b-e8c3eff5a2c0","body_text":"Abstract\nBackground\nAccessory and cavitated uterine mass (ACUM) is a newly recognized Mullerian anomaly and essentially a benign lesion. The normal-looking uterine cavity makes it different from other Mullerian anomalies. ACUMs are included in Group 4 of the updated embryological-clinical classification for female genito-urinary malformations published in Human Reproduction Update. The usual presentation is refractory dysmenorrhea in young females not responding to usual drugs. TVUS and MRI is utilised to reach the diagnosis. The common differential diagnosis are diffuse adenomyosis, myoma, and adenomyoma. Owing to its new identity among the causes of severe dysmenorrhea, its recognition is of great importance for girls suffering from the monthly agony. Our case is novel with respect to findings of concurrent ACUM and borderline ovarian tumour where treating surgeon will have tendency to give more importance to the management of the ovarian neoplasia. The idea behind reporting this case is to increase awareness for concurrent surgical treatment of benign lesions in the eligible patients.\nCase Presentation\nWe are reporting a case following the CARE guidelines. A girl in her late adolescence was referred to our tertiary care oncology centre with an imaging suggestive of an ovarian tumour diagnosed coincidentally during work up for dysmenorrhea. Her chief complaints were severe and refractory dysmenorrhea since menarche. On MRI, the coexisting tiny lesion measuring 10*8 mm within the myometrium caught our attention as a probable cause of dysmenorrhea. The lesion fulfilled all the criteria for ACUM. Accordingly, she was planned for exploratory laparotomy and proceed with frozen section. The procedure executed was fertility-sparing staging of borderline tumour along with excision of the ACUM. The histopathology report confirmed it to be a stage 1a serous borderline ovarian tumour with concurrent ACUM. The patient has been planned for observation and is currently free of dysmenorrhea.\nConclusions\nThe diagnosis of ACUM is essential for its timely and appropriate treatment. Early surgical treatment can provide the symptom relief to these young women.\nSimilar content being viewed by others\nReferences\nAzuma Y, Taniguchi F, Wibisono H, Ikebuchi A, Moriyama M, Harada T. A case report of an accessory and cavitated uterine mass treated with total laparoscopic hysterectomy. Yonago Acta Med. 2021;64(2):207–9.\nJain N, Verma R. Imaging diagnosis of accessory and cavitated uterine mass, a rare mullerian anomaly. Indian J Radiol Imaging. 2014;24(2):178–81.\nAcien P, Bataller A, Fernandez F, Acien MI, Rodriguez JM, Mayol MJ. New cases of accessory and cavitated uterine masses (ACUM): a significant cause of severe dysmenorrhea and recurrent pelvic pain in young women. Hum Reprod. 2012;27(3):683–94.\nAcien P, Acien MI. The history of female genital tract malformation classifications and proposal of an updated system. Hum Reprod Update. 2011;17(5):693–705.\nBedaiwy MA, Henry DN, Elguero S, Pickett S, Greenfield M. Accessory and cavitated uterine mass with functional endometrium in an adolescent: diagnosis and laparoscopic excision technique. J Pediatr Adolesc Gynecol. 2013;26(4):e89-91.\nAcknowledgements\nNot applicable.\nFunding\nNone.\nAuthor information\nAuthors and Affiliations\nContributions\nDB, A, UB, DB and RJ contributed in writing the manuscript. A did the literature search. AD performed the histological examination of the surgical specimens. All authors read and approved the final manuscript.\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors declare that they have no conflict of interest.\nEthical Approval\nThe manuscript has been read and approved by all the authors, that the requirements for authorship have been met, and each author believes that the manuscript represents honest work.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nBarmon, D., Aparajita, Baruah, U. et al. “Deciphering Dysmenorrhea in an Adolescent Girl with Borderline Ovarian Tumour”: A Case Report on an Accessory and Cavitated Uterine Mass (ACUM). Indian J Gynecol Oncolog 21, 9 (2023). https://doi.org/10.1007/s40944-022-00686-1\nReceived:\nRevised:\nAccepted:\nPublished:\nVersion of record:\nDOI: https://doi.org/10.1007/s40944-022-00686-1","source_license":"CC0","license_restricted":false}