Background: Accessory and cavitated uterine masses (ACUMs) are rare congenital mullerian anomalies where isolated cavitated lesions are located in the lateral myometrium with no communication with the uterine cavity or fallopian tube. The diagnostic criteria for the diagnosis of ACUM includes: (1) isolated mass in lateral myometrium/broad ligament, (2) no communication with a fallopian tube or uterine cavity, (3) cavity has myometrial mantle surrounding the endometrium, (4) cavity lined by functional endometrium, (5) contains dark brown hemorrhagic fluid. The woman usually presents at a younger age with dysmenorrhea. Even though there is an assumption that ACUM can be asymptomatic, there is a scarcity of data.
Case description: We present a case of ACUM which was mistaken for a rudimentary horn in a woman who was evaluated for new-onset menstrual irregularity.
Conclusion: Knowledge and awareness of this entity will help us to consider preoperative diagnosis of ACUM and provide better treatment options to women.
Clinical significance: All women diagnosed to have ACUM may not require surgical intervention if it is an incidental finding when evaluated for other conditions.
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