MRI in the Evaluation of Accessory Cavitated Uterine Mass: A Case Report

Accessory Cavitated Uterine Mass (ACUM) is a rare Müllerian anomaly typically seen in adolescents or young women presenting with severe dysmenorrhoea. It can mimic other pelvic pathologies such as adenomyosis or endometriosis. Magnetic Resonance Imaging (MRI) plays a pivotal role in identifying and characterising the lesion preoperatively. The present case report includes a case of a 21-year-old unmarried woman presenting with severe dysmenorrhoea since menarche. MRI revealed a well-defined intramyometrial cystic lesion near the right uterine cornua, which was mildly hyperintense on T1 and heterogeneously hyperintense on T2, without communication to the endometrial cavity-findings consistent with ACUM. The diagnosis was confirmed after laparoscopic excision and histopathological analysis, resulting in complete postoperative symptom relief. ACUM is a rare but treatable cause of severe dysmenorrhoea in young females. MRI offers crucial diagnostic clarity, allowing for early surgical intervention and improved quality of life.