Laparoscopic Management of Accessory Cavitated Uterine Mass: A Report of Two Cases and Review of Literature

Panwar, Akshita; Davis, Amenda Ann; Lata, Kusum; Sharma, Seema; Kriplani, Alka

doi:10.1089/gyn.2020.0019

Cited by 5 publications

(9 citation statements)

References 16 publications

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“…Dissection of the uterovesical fold has also been cited to facilitate safe access to the laterally placed ACUM 33 . Vasopressin infiltration into the uterine–ACUM serosal interface to aid with haemostasis has been reported by almost all authors 4,6,7,10,11,13–17,38,46 . The overlying serosa is incised with monopolar energy 4,6 and ACUM enucleation is performed in a circumferential manner along the ACUM–myometrial interface with the use of bipolar energy; in contrast to a myomectomy, where dissection advances along a pseudocapsule 6 .…”

Section: Sclerotherapymentioning

confidence: 99%

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Accessory cavitated uterine malformations (ACUMs): an unfamiliar cause of dysmenorrhoea

Setty

Naftalin

2022

The Obstetric & Gynaecologis

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Key Content Accessory cavitated uterine malformations (ACUMs) are isolated cavitated lesions within the lateral aspect of the myometrium, inferior to the attachment of the round ligament. They are a rare Müllerian anomaly and are increasingly recognised as a cause for severe dysmenorrhoea and pelvic pain. ACUMs can be diagnosed with ultrasound and magnetic resonance imaging, where they appear as well‐defined lesions with a central cavity containing haemorrhagic content, surrounded by a myometrial mantle. On histological examination, the cavity is lined by functional endometrial glands and stroma. Recognised treatments include hormonal suppression, destruction of the endometrial lining by alcohol sclerotherapy, or complete surgical excision, which has demonstrated curative results. Learning Objectives To know what ACUMs are and recognise them as a cause of dysmenorrhoea and pelvic pain. To be able to diagnose an ACUM with the use of ultrasound, MRI and histological findings if surgically excised. To be able to counsel patients with ACUMs on the different management options, including conservative, medical and surgery. Ethical issues All women with ACUMs are currently offered surgical excision, but is it appropriate to offer this, to patients as young as 13 years old, with no long‐term data on the effect of surgery on future fertility?

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Section: Sclerotherapymentioning

confidence: 99%

“…They rarely exceed 35 mm in mean diameter. Various techniques have been described for specimen retrieval, including the use of colpotomy, 4 morcellation 10,15,23,46 and specimen retrieval bags 7,8,16,33 …”

Section: Sclerotherapymentioning

confidence: 99%

Accessory cavitated uterine malformations (ACUMs): an unfamiliar cause of dysmenorrhoea

Setty

Naftalin

2022

The Obstetric & Gynaecologis

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“…Vasopressin infiltration into the uterine-ACUM junction sub-serosal interface to aid with hemostasis has been reported by most authors performing laparoscopic excision. 5,7,10,11,13,14,17,18,42,44,59,63,64 We also, in our practice, use vasopressin infiltration not only to reduce hemostasis but also to enable easy dissection.…”

Section: Surgical Excisionmentioning

confidence: 99%

Accessory cavitated uterine malformation (ACUM): A hidden face of dysmenorrhea

Mondal¹,

Bhave²

2022

IJOGR

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: Accessory cavitated uterine malformations, or mass (ACUM) is a Mullerian anomaly which increasingly recognized as a cause of severe dysmenorrhoea and pelvic pain.: To know what ACUMs are and recognize their clinical presentation, able to diagnose an ACUM using ultrasound or MRI; and counsel patients with ACUMs on the different management options, including conservative, medical, and surgery.: ACUMs are less rare than previously believed; hence ACUM diagnosis is essential in clinically suspicious cases via ultrasound and MRI, and intra-operative assessment of uterine morphology and laparoscopic surgical excision is the definitive treatment for ACUM.

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“…Some authors reported cases where the preoperative diagnosis was a noncommunicating horn of a unicornuate uterus with haematometra, and later were diagnosed as a juvenile cystic adenomyoma ( Dadhwal et al, 2017 ; Kriplani et al, 2011 ). More recently, some investigators suggested that an accessory cavitated uterine mass (ACUM) should be considered in the differential diagnosis of dysmenorrhoea in adolescents ( Di Spiezio et al, 2015 ; Jain and Verma, 2014 ; Panwar et al, 2020 ). ACUM is a rare form of a Müllerian anomaly, that can result from gubernaculum dysfunction that may lead to persistence or duplication of paramesonephric ducts forming an accessory cavity ( Shah et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive management of juvenile cystic adenomyoma: report of three cases

Said¹,

Afaneh²,

Zaghmout³

et al. 2021

Facts Views Vis ObGyn

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Background: Juvenile cystic adenomyosis (JCA) represents a rare form of focal adenomyosis in young women. Objectives: To determine safety and effectiveness of minimally invasive surgery (MIS for JCA). Materials and Methods: Three patients aged 16-30 years old presented with chronic pelvic pain [2016 - 2019]. Hormonal treatment failed in two cases. Cystic lesions in the myometrium (n=2), and the broad ligament (n=1) was detected on transvaginal 2D ultrasound (TV 2D US) and/or magnetic resonance imaging (MRI). The cyst was separate from the endometrium in all the cases, within the myometrium in two patients and in the right broad ligament in one case. The cystic lesions were confirmed on laparoscopy; and laparoscopic excision of the cysts with adequate repair of the myometrial beds were performed in all cases with fertility preservation. Robotic assistance was chosen in one case in an attempt to avoid injury of the fallopian tube based on the cyst location during a previous laparoscopy. The endometrial cavity was entered in one case. Main outcome measures: Absence of intraoperative complications and relief of presenting symptoms postoperatively. Results: Pathology report confirmed the diagnosis of JCA is all cases. There were no intraoperative complications. All three patients reported relief of their symptoms 6 to 8 months after surgery. No recurrence of the JCA was reported using TV 2D US in all cases. Conclusions: MIS could be the treatment of choice for patients with JCA. The technique described in our study is safe, effective, and easy to master in experienced hands. What is new? Value of MIS in treatment of patients with JCA.

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Laparoscopic Management of Accessory Cavitated Uterine Mass: A Report of Two Cases and Review of Literature

Cited by 5 publications

References 16 publications

Accessory cavitated uterine malformations (ACUMs): an unfamiliar cause of dysmenorrhoea

Accessory cavitated uterine malformations (ACUMs): an unfamiliar cause of dysmenorrhoea

Accessory cavitated uterine malformation (ACUM): A hidden face of dysmenorrhea

Minimally invasive management of juvenile cystic adenomyoma: report of three cases

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