Surgical treatment of patient with an accessory and cavitated uterine mass (ACUM)
Volkov O.A., Shramko S.V., Kоshevarova V.A., Razvozzhaev Yu.B., Rassadovsky M.V.
Background: Accessory and cavitated uterine mass (ACUM) is a rare form of female genital malformation associated with gubernaculum dysfunction. The clinical picture of the disease is characterized by severe dysmenorrhea and chronic pelvic pain which do not respond to conservative therapy. When performing ultrasound or MRI of the pelvic organs, ACUM appears as a large mass in the pelvic cavity.
Case report: The article presents a clinical case of complex diagnosis and surgical treatment of ACUM in a 30-year-old nullipara who presented to the clinic with severe dysmenorrhea and recurrent pelvic pain. Planned laparoscopic excision of ACUM was performed after a follow-up examination. The histological examination revealed the presence of a secretory endometrium surrounded by muscle tissue. In the postoperative period, there was a complete resolution of the symptoms of dysmenorrhea and pelvic pain.
Conclusion: Verification of the diagnosis presents significant difficulties due to the rare prevalence of pathology and the lack of alertness among specialists. Magnification of the image and less traumatic intervention make laparoscopic and robotic surgery the most preferred method for the treatment of ACUM.
Authors’ contributions: Volkov O.A. – developing the concept and design of the study; Volkov O.A., Kоshevarova V.A., Razvozzhaev Yu.B., Rassadovsky M.V. – collecting and processing the material; Shramko S.V. – editing the manuscript.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The research was approved by the Ethical Review Board of the Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the RMACPE, Ministry of Healthcare of the Russian Federation.
Patient Consent for Publication: The patient signed an informed consent to the publication of her data and associated images.
For citation: Volkov O.A., Shramko S.V., Kоshevarova V.A., Razvozzhaev Yu.B., Rassadovsky M.V.
Surgical treatment of patient with an accessory and cavitated uterine mass (ACUM).
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (4): 192-197 (in Russian)
https://dx.doi.org/10.18565/aig.2025.243
Keywords
accessory and cavitated uterine mass
ACUM
Müllerian anomaly
dysmenorrhea
laparoscopy
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Received 02.09.2025
Accepted 12.02.2026
About the Authors
Oleg A. Volkov, MD, Teaching Assistant at the Department of Obstetrics and Gynecology, Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, 5 Stroiteley Ave., Novokuznetsk, 654005, Russia, +7(996)332-98-08, volkovoa@icloud.com, https://orcid.org/0000-0002-3271-7167Svetlana V. Shramko, Dr. Med. Sci., Associate Professor, Professor at the Department of Obstetrics and Gynecology, Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, 5 Stroiteley Ave., Novokuznetsk, 654005, Russia, +7(3843)324-750, shramko_08@mail.ru,
https://orcid.org/0000-0003-1299-165X
Victoria A. Koshevarova, obstetrician-gynecologist, reproductive specialist, ultrasound diagnostics specialist, MEDIKA-2 LLC, Mother and Child Siberia Group of Companies,
30 Sechenova str., Novokuznetsk, 654041, Russia, +7(960)119-35-45, vikikosh31@gmail.com, https://orcid.org/0009-0006-0323-1455
Yuri B. Razvozzhaev, Associate Professor, Head of the Department of Radiation Diagnostics, Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, 5 Stroiteley Ave., Novokuznetsk, 654005, Russia, +7(3843)324-750, Yu_simrazv@mail.ru, https://orcid.org/0000-0003-3203-2261
Mikhail V. Rassadovsky, Head of the Pathological Anatomical Department, Medical Center "Avicenna", Mother and Child Group of Companies, 17 Kommunisticheskaya str., Novosibirsk, 630099, Russia, +7(383)363-30-03, ext.1635, m.rassadovskiy@mcclinics.ru, https://orcid.org/0009-0007-5362-1475
Corresponding author: Oleg A.Volkov, volkovoa@icloud.com
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