Bansal Hospital, Bhopal, Madhya Pradesh, India.
Int J Gynaecol Obstet. 2023 Aug;162(2):409-432. doi: 10.1002/ijgo.14681. Epub 2023 Feb 7.
An accessory cavitated uterine mass (or malformation) (ACUM) is an isolated cystic uterine lesion located at the lateral aspect of the myometrium just below the insertion of the round ligament. Often the source of severe dysmenorrhea and pelvic pain, this condition is classified as a Müllerian abnormality. Understanding ACUMs, recognizing their clinical appearance, diagnosing an ACUM with ultrasound or magnetic resonance imaging, and advising patients about conservative, medicinal, and surgical treatment options is important to all clinicians. Although ACUM primarily presents with severe dysmenorrhea but can have other clinical symptoms, we have provided a few sample cases to help clinicians prepare for ACUM encounters. We also reviewed the other published literature available on ACUM regarding clinical presentation, etiology, and management. Last but not least, based on our research and the work of others, we offer a set of characteristics that will be useful in diagnosing and treating ACUM. ACUM diagnosis is crucial in clinically suspicious circumstances, and early treatment significantly enhances patients' quality of life.
附件囊性子宫肿块(或畸形)(ACUM)是一种位于子宫肌层外侧、圆韧带插入下方的孤立囊性子宫病变。常引起严重痛经和盆腔疼痛,这种情况被归类为 Müllerian 异常。了解 ACUM、识别其临床特征、通过超声或磁共振成像诊断 ACUM 以及向患者提供关于保守、药物和手术治疗选择的建议,对所有临床医生都很重要。尽管 ACUM 主要表现为严重痛经,但也可能有其他临床症状,我们提供了一些示例病例,以帮助临床医生为 ACUM 就诊做好准备。我们还回顾了其他关于 ACUM 的临床表现、病因和治疗的已发表文献。最后但同样重要的是,根据我们的研究和其他人的工作,我们提出了一组有助于诊断和治疗 ACUM 的特征。在临床可疑情况下,ACUM 的诊断至关重要,早期治疗可显著提高患者的生活质量。