Accessory and cavitated uterine masses: a case series and review of the literature

S Dekkiche; E Dubruc; M Kanbar; A Feki; M Mueller; J-Y Meuwly; P Mathevet

doi:10.3389/frph.2023.1197931

Accessory and cavitated uterine masses: a case series and review of the literature

Front Reprod Health. 2023 Aug 17:5:1197931. doi: 10.3389/frph.2023.1197931. eCollection 2023.

Authors

S Dekkiche¹, E Dubruc², M Kanbar³, A Feki⁴, M Mueller⁵, J-Y Meuwly^{6

7}, P Mathevet^{1

7}

Affiliations

¹ Gynaecology Department, Department Women-Mother-Child, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
² Institute of Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
³ Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
⁴ Department of Obstetrics and Gynaecology, HFR Fribourg Hôpital Cantonal, Fribourg, Switzerland.
⁵ Department of Obstetrics and Gynaecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
⁶ Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
⁷ Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland.

Abstract

Objectives: The purpose of this study is to report nine patients of young women who underwent a surgical treatment of an accessory and cavitated uterine mass (ACUM) in our hospital between 2014 and 2022 and review all cases described in the literature.

Material and methods: The principal outcomes measured are the imaging techniques used to determine the diagnosis, the type of surgery used and the post-operative evolution of symptoms. We also report and analyse the 79 patients found in the literature since 1996 in addition to our 9 patients.

Results: Surgical excision is the only long-lasting treatment. Small invasive surgery with laparoscopic access is the gold standard and most widely used (83.0%). Some new therapeutic procedures have been recently described of which ethanol sclerotherapy seems very promising. Post-operatively, 54.5% of patients have a complete relief of symptoms. MRI is the best imaging technique to identify ACUM. Finally, we refine the description of this pathology and give a more precise definition of it.

Conclusion: Through our literature review and the analysis of our cases, we want to underline an important diagnostic criterion of this pathology: the fallopian tube on the homolateral side of the ACUM never communicates with the latter. It is a capital element for differential diagnosis.

Keywords: ACUM; Müllerian anomalies; chronic pelvic pain; dysmenorrhea; uterine malformations.