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Imaging features of accessory cavitated uterine mass (ACUM): a peculiar yet correctable cause of dysmenorrhea


Accessory cavitated uterine mass (ACUM) is a rare form of developmental mullerian anomaly which causes chronic pelvic pain, dysmenorrhea and infertility in young females. It is a non-communicating, accessory cavity within an otherwise normal uterus, lined by functional endometrium and surrounded by myometrium-like smooth muscle cells which imparts it uterus-like appearance. USG and MRI are the imaging modalities which help in reaching the diagnosis. Knowledge of this entity and awareness of its imaging features can help diagnose this often underdiagnosed and surgically correctable cause of dysmenorrhea.

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  1. Supermaniam S, Thye WL. Diagnosis and laparoscopic excision of accessory cavitated uterine mass in young women: Two case reports. Case Rep Womens Health. 2020 Apr 1;26:e00187.

    Article  Google Scholar 

  2. Iranpour P, Haseli S, Keshavarz P, Dehghanian A, Khalili N. Pelvic Pain and Adnexal Mass: Be Aware of Accessory and Cavitated Uterine Mass. Case Rep Med. 2021 Feb 11;2021:e6649663.

    Google Scholar 

  3. Setty, T, Naftalin, J, Jurkovic, D. Accessory cavitated uterine malformations (ACUMs): an unfamiliar cause of dysmenorrhoea. The Obstetrician & Gynaecologist 2022; 24: 40– 49.

    Article  Google Scholar 

  4. Jain N, Verma R. Imaging diagnosis of accessory and cavitated uterine mass, a rare mullerian anomaly. Indian J Radiol Imaging. 2014;24(2):178–81.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Betzler N, Brunes M, Anfelter P, Wedlund L, Persson J, Epstein E. Sonografic features of accessory cavitated uterine mass (ACUM) successfully treated with robotic assisted laparoscopic surgery- a case report. Clin Obstet Gynecol Reprod Med [Internet]. 2019 [cited 2021 Sep 12];5(6). Available from:

  6. Putta T, John R, Simon B, Sathyakumar K, Chandramohan A, Eapen A. Imaging Manifestations of Accessory Cavitated Uterine Mass—A Rare Mullerian Anomaly. Indian J Radiol Imaging [Internet]. 2021 Sep 7 [cited 2021 Sep 15]; Available from:

  7. Acién P, Bataller A, Fernández F, Acién MI, Rodríguez 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 Mar 1;27(3):683–94.

    Article  PubMed  Google Scholar 

  8. Peyron N, Jacquemier E, Charlot M, Devouassoux M, Raudrant D, Golfier F, et al. Accessory cavitated uterine mass: MRI features and surgical correlations of a rare but under-recognised entity. Eur Radiol. 2019 Mar;29(3):1144–52.

    Article  CAS  PubMed  Google Scholar 

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SG: Literature search, manuscript preparation. SM: Conception and design of work, manuscript preparation and editing. SV, NM, SRM, VK: Manuscript—editing. All authors read and approved the final manuscript.

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Correspondence to Smita Manchanda.

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Gupta, S., Manchanda, S., Vyas, S. et al. Imaging features of accessory cavitated uterine mass (ACUM): a peculiar yet correctable cause of dysmenorrhea. Abdom Radiol 48, 1100–1106 (2023).

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