Accessory and cavitated uterine mass with functional endometrium in an adolescent: diagnosis and laparoscopic excision technique.

Study Objective: Accessory and cavitated uterine masses (ACUM) with functional endometrium can be treated successfully with laparoscopic excision. The objectives of this report are to illustrate the surgical technique used for the removal of this uterine wall mass and to discuss the patient's clinical course and outcomes.

Design: Surgical technique and description of 1 case.

Setting: Department of Obstetrics and Gynecology, University Hospitals Case Medical Center.

Participant(s): A 16-year-old adolescent presented with severe dysmenorrhea and pelvic pain. Ultrasonographic examination and MRI demonstrated a cystic uterine wall mass distinct from the endometrial cavity.

Intervention(s): Laparoscopic excision of uterine mass.

Results: Pathologic examination of the mass was consistent with an accessory and cavitated uterine mass. A 9-month follow-up after surgical excision of the mass confirmed complete symptom resolution.

Conclusions: ACUM is a unique and not uncommon pathologic category in the adolescent and young adult population. It is associated with severe and intractable dysmenorrhea and pelvic pain. Laparoscopic excision of these masses is justifiable, safe and feasible.