Accessory Cavitated Uterine Mass with Associated Chocolate Cyst and Ureteric Endometrioma: A Case Report

Accessory Cavitated Uterine Malformation (ACUM) is a Müllerian anomaly characterised by a non communicating uterine cavity lined with functional endometrium and surrounded by myometrium. ACUM is an uncommon cause of pelvic pain and dysmenorrhoea. This condition was associated with a ureteric endomet...

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Main Authors: Sanjay Mhalasakant Khaladkar, Tanushree Sharma, Parag Patil, Onkar Sangha, Jhanvi Patel
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-06-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/articles/PDF/21131/79143_CE[Ra1]_F(SL)_QC(PS_IS)_PF1(RI_IS)_redo_PFA(IS)_PN(IS).pdf
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Summary:Accessory Cavitated Uterine Malformation (ACUM) is a Müllerian anomaly characterised by a non communicating uterine cavity lined with functional endometrium and surrounded by myometrium. ACUM is an uncommon cause of pelvic pain and dysmenorrhoea. This condition was associated with a ureteric endometrial deposit and endometrioma, highlighting an unusual presentation. A 19-year-old unmarried female patient presented with complaints of right flank pain during her menstrual cycles, as well as irregular menstrual cycles alternating between hypomenorrhoea and polymenorrhagia since the onset of menstruation five years prior. Ultrasound and Magnetic Resonance Imaging (MRI) revealed a well-defined solid lesion on the right lateral wall of the uterine fundic region, located near the attachment of the round ligament. The right ovary displayed a cyst with multiple internal echoes, exhibiting a ground-glass appearance on ultrasound and a T2 shading effect on MRI, suggestive of an endometriotic cyst. Notably, right-sided hydroureteronephrosis was observed due to a hypoechoic solid lesion near the ureterovesical junction on ultrasound, which appeared T2 hypointense on MRI, indicative of an endometriotic deposit. The present case illustrates the utility of ultrasound and MRI in diagnosing ACUM, along with the associated chocolate cyst and ureteric endometrioma, resulting in obstructive uropathy-an exceptionally rare combination.
ISSN:2249-782X
0973-709X