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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(03): 545-550
DOI: 10.1055/s-0041-1735504
Original Article

Imaging Manifestations of Accessory Cavitated Uterine Mass—A Rare Mullerian Anomaly

Tharani Putta 
1   Department of Radiology, AIG Hospitals, Hyderabad, Telangana, India
,
Reetu John
2   Department of Radiology, CMC, Vellore, Tamil Nadu, India
,
Betty Simon
2   Department of Radiology, CMC, Vellore, Tamil Nadu, India
,
Kirthi Sathyakumar 
2   Department of Radiology, CMC, Vellore, Tamil Nadu, India
,
Anuradha Chandramohan
2   Department of Radiology, CMC, Vellore, Tamil Nadu, India
,
Anu Eapen
2   Department of Radiology, CMC, Vellore, Tamil Nadu, India
› Author Affiliations Funding None.
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Abstract

Context Accessory cavitated uterine mass (ACUM) is an uncommon and under-recognized entity with distinct imaging characteristics and causing significant patient distress. Differentiating it from its other clinical and radiological differentials is therefore extremely important and prevents delay in surgical management which is the treatment of choice.

Aims The aim of the study is to describe the MRI appearance of the surgically and pathologically proven ACUM cases from our institution in the last 2 years.

Settings and Design This is a retrospective study in a tertiary care hospital in South India.

Methods and Material We reviewed the clinical presentations and imaging findings of seven surgically proven cases of ACUM qualifying the proposed diagnostic criteria.

Results All patients presented with chronic pelvic pain, dysmenorrhea, and prolonged post-menstrual pain. MRI in all seven cases showed an intramural, noncommunicating, and cavitating lesion near the uterine cornua with internal contents similar to that of endometrioma. Although the cavity was lined by endometrium in all the cases (proven in pathology), it was well appreciable on MRI in only five cases. The rest of the uterine myometrium and main endometrial cavity were normal with no features of adenomyosis.

Conclusion MRI is a reliable diagnostic tool for accurate diagnosis of ACUM, and more importantly, in distinguishing it from other causes of chronic pelvic pain like adenomyosis and endometriosis and other imaging differentials like adenomyoma, noncommunicating uterine horn, and degenerating leiomyoma.

Keywords

uterine cavity - ACUM - cavitated uterine mass - cystic adenomyoma - noncommunicating uterine horn


Publication History

Article published online:
07 September 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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