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Accessory cavitated uterine malformation (ACUM): A scoping review
Stefan Timmerman1,2, Lauren Stubbe1, Thierry Van den Bosch1,2
1Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Acta Obstetricia Et Gynecologica Scandinavica
|February 12, 2024
Summary
Accessory cavitated uterine malformation (ACUM) is a rare uterine anomaly. This review defines ACUM and highlights the need for standardized diagnosis and management to improve patient outcomes.
Area of Science:
- Reproductive Medicine
- Gynecologic Pathology
- Medical Imaging
Background:
- Accessory cavitated uterine malformation (ACUM) is a rare uterine anomaly, previously described under various terms.
- ACUM involves a noncommunicating, accessory uterine cavity within the myometrium.
- Understanding ACUM's characteristics is crucial for accurate diagnosis and management.
Purpose of the Study:
- To systematically review and define Accessory cavitated uterine malformation (ACUM) in the existing literature.
- To identify morphological, epidemiological, and clinical characteristics of ACUM.
- To analyze current management strategies and highlight knowledge gaps for ACUM.
Main Methods:
- Systematic literature search across three databases for cystic myometrial lesions.
- Inclusion of cases fitting common ACUM definitions.
- Documentation of clinical and imaging characteristics, adhering to PRISMA guidelines.
Main Results:
- 115 cases of ACUM identified across 53 articles.
- Median age at symptom onset was 17 years, with dysmenorrhea post-menarche.
- Ultrasound and MRI findings described; 83% managed surgically, with a trend towards non-surgical options.
Conclusions:
- ACUM is often underdiagnosed due to similarities with other myometrial masses.
- A unified terminology and definition for ACUM are proposed based on review findings.
- Further prospective studies are needed to investigate ACUM management and long-term outcomes, including fertility and pregnancy.
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