Supermaniam Sevellaraja, Thye Wei Lin
Mahkota Medical Centre, Suite 105, Mahkota Medical Centre, No 3, Mahkota Melaka, Jalan Merdeka, 75000 Melaka, Malaysia.
Case Rep Womens Health. 2020 Mar 3;26:e00187. doi: 10.1016/j.crwh.2020.e00187. eCollection 2020 Apr.
An accessory cavitated uterine mass (ACUM) is a rare congenital Mullerian anomaly where an accessory cavity with normal endometrial lining lies within a normally functioning uterus. It is common among young and nulliparous women presenting with severe dysmenorrhea and infertility.
We present two cases of ACUM. The first case was a 22-year-old woman who presented with severe dysmenorrhea and was initially misdiagnosed with non-communicating rudimentary horn The second case was a 36-year-old woman who presented with primary infertility and dysmenorrhea. Gynecological examination and ultrasound scanning were done for both patients. Subsequently, laparoscopic excision of the ACUM was performed on both patients. Histopathological examination confirmed the diagnosis. Postoperatively, both patients did well, with no further dysmenorrhea. The second patient conceived spontaneously at the first attempt and at the time of writing was 33 weeks pregnant without any maternal or fetal problems.
The diagnosis of ACUM is often confused with non-communicating rudimentary uterine horn, true cavitated adenomyosis and degenerating fibroids. It is important to understand and distinguish ACUM. A thorough history, detailed gynecological examination and correct radiological modalities are critical to a proper diagnosis so that the correct surgery can be performed, especially when fertility is desired.
副腔隙性子宫肿块（ACUM）是一种罕见的先天性苗勒管异常，其中一个具有正常子宫内膜衬里的副腔位于功能正常的子宫内。它在出现严重痛经和不孕的年轻未生育女性中很常见。
我们报告两例ACUM病例。第一例是一名22岁女性，表现为严重痛经，最初被误诊为非交通性残角子宫。第二例是一名36岁女性，表现为原发性不孕和痛经。对两名患者均进行了妇科检查和超声扫描。随后，对两名患者均进行了腹腔镜下ACUM切除术。组织病理学检查确诊。术后，两名患者情况良好，不再有痛经。第二名患者首次尝试即自然受孕，在撰写本文时已怀孕33周，母婴均无问题。
ACUM的诊断常与非交通性残角子宫、真性腔隙性子宫腺肌病和变性肌瘤相混淆。了解和区分ACUM很重要。详细的病史、细致的妇科检查和正确的影像学检查方法对于正确诊断至关重要，以便能够进行正确的手术，尤其是在有生育需求时。
