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The main causes of secondary dysmenorrhoea are uterine and vaginal anomalies, menstrual outflow obstruction, endometriosis, adenomyosis and uterine myoma. This study reports a rare case of accessory and cavitated uterine mass (ACUM), a rare mullerian anomaly, related to dysfunction of gubernaculum which is a new but significant entity causing severe dysmenorrhoea and chronic pelvic pain. ACUM was diagnosed in a multiparous female who was being treated on the lines of endometriosis without relief in symptoms. [ABSTRACT FROM AUTHOR]