Non-puerperal uterine inversion associated with adenosarcoma of the uterus: A case report

• Published in: Case reports in women's health Vol. 22; p. e00107
• Main Authors: Salameh, Alaa Eddin K., Aljaberi, Loay M., Almarzooqi, Raha M., Khloof, Deyab R., Abu Ras, Suhaib A., Tabanja, Raed
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-04-2019; Elsevier
• Subjects: Adenosarcoma of the uterus; Non-puerperal uterine inversion; Uterine sarcoma; Non-puerperal uterine inversion; Uterine sarcoma; Adenosarcoma of the uterus
• ISSN: 2214-9112; 2214-9112
• DOI: 10.1016/j.crwh.2019.e00107

Uterine inversion is an uncommon condition characterized by the invagination of the fundus of the uterus through the vagina and is extremely rare in non-pregnancy settings. Non-puerperal uterine inversion is usually precipitated by tumours exerting traction force on the fundus of the uterus, turning the uterus partially or completely inside out. It is most frequently associated with benign tumours such as submucosal leiomyomas; however, malignant tumours are a rare association.
A 67-year-old woman, G18P18, presented to the emergency department with a bleeding mass that had acutely prolapsed out of the vagina. She had a two-year history of postmenopausal bleeding but had not sought medical advice. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathological evaluation revealed an adenosarcoma of the uterine fundus, measuring 6 cm in its largest diameter, which invaded the myometrium only superficially. The patient recovered well from the operation with no complications and was referred to an oncologist for further treatment. A computerized tomography scan with intravenous contrast showed no evidence of metastasis.
Uterine sarcoma is a malignant tumour of the uterus that typically presents with vaginal bleeding, and rarely as prolapsed uterine inversion. Uterine inversion rarely occurs outside the puerperal setting; however, when it does occur, the possibility of an underlying malignancy should not be neglected.
•Uterine sarcoma is a rare malignant tumour of the uterus. Uterine adenosarcoma is the rarest subtype of uterine sarcoma.•Uterine sarcomas may be associated with uterine inversion with prolapse.•The possibility of malignancy should not be neglected in non-puerperal uterine inversion patients.