VP05.07: Transrectal sonography in diagnosis of accessory and cavitated uterine mass in adolescent females

Accessory and cavitated uterine mass (ACUM) is a newly recognised and rare mullerian anomaly. It is a uterus like mass showing a cavity lined by endometrial glands and stroma that are surrounded by smooth muscle cells resembling myometrium. ACUM can be located in myometrium or in adnexa. Myometrial ACUM is not connected to the endometrial cavity. As the cavity distends with the menstrual blood there is severe dysmenorrhea and chronic lower abdominal pain in young females. Transrectal sonography is extremely useful in adolescent and unmarried females. We present two cases of ACUM in girls aged 14 and 19 years, referred for severe debilitating dysmenorrhea. The presence of endometrioma like cystic mass within the myometrium, normal endometrium and ovaries, relevant history and high degree of suspicion were important tools in making correct diagnosis. Diagnosis of ACUM was suspected on transabdominal scan. 3D transrectal sonography demonstrated the two lateral angles of the endometrial cavity, differentiating ACUM from rudimentary and cavitated uterine horn. In both our cases diagnosis of ACUM was confirmed on laparoscopy and histopathology. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.