2024 Volume 40 Issue 2 Pages 134-139
Accessory cavitated uterine masses (ACUM) is rare, and patients present with severe dysmenorrhea at a young age. Surgical treatment is recommended due to the limited efficacy of drug therapy. Here, we report two cases of ACUM diagnosed by laparoscopic surgery performed at our hospital.
Case 1 was of a 24-year-old woman with lower abdominal pain that had persisted for 2 years who was diagnosed with ACUM by her previous doctor. Her symptoms were relieved by oral medication, but only temporarily before worsening. She was referred to our department for surgery. Case 2 was of a 23-year-old woman who was diagnosed with cystic adenomyosis at the age of 14 years, and was referred to our department for surgery because the lesion was increasing after 8 years of medical treatment. Both patients underwent laparoscopic cystectomy. Based on the postoperative histopathology, we diagnosed both patients with ACUM.
Because the effectiveness of drug therapy is limited in ACUM, clinicians should consider surgery. However, it is difficult to determine the extent of resection at the time of cyst excision, and the possibility of residual tumor tissue after resection cannot be ruled out. In fact, there have been reports of patients with residual symptoms after surgery. At present, reports with long-term follow-up are limited; thus, it is necessary to report additional cases in the future, including longer-term follow-up and postoperative course.
