Chronic uterine inversion associated with uterine leiomyoma misdiagnosed as cervical fibroid: a case report

Abstract

Chronic inversion of uterus is a rare clinical entity which is usually associated with obstetrics complication and rarely with gynaecological disorder like fibroid present at fundus of uterus. We here present a case of 40-year-old female P3L3 with chronic inversion of uterus with fundal fibroid which present with 3year history of abnormal vaginal bleeding. Ultrasonography and MRI revealed cervical fibroid. Due to AUB secondary to cervical fibroid decision of hysterectomy was taken. On laparotomy chronic uterine inversion was present which was corrected by haultain’s procedure. Then hysterectomy was done. Histopathology report suggestive of uterine leiomyoma at fundus of uterus. Chronic uterine inversion associated most commonly with fundal submucous leiomyoma. Other causes are leiomyosarcoma, endometrial carcinoma, cervical carcinoma, rhabdomyosarcoma, mixed mullerian sarcoma. It is an extremely rare gynaecological condition and can be misdiagnosed as cervical fibroid, advanced cervical malignancy or other causes of AUB in females. It could be labelled as gynaecological near miss so a high index of suspicion is necessary for it’s diagnosis.

A Case of Nonpuerperal Uterine Inversion Caused by Cervical Cancer

“…The occupying tumor appears similar to a cervical tumor in some cases of nonpuerperal uterine inversion. However, no case associated with cervical cancer has been reported previously [ 11 , 12 ]. To the best of our knowledge, this is the first reported case of nonpuerperal uterine inversion caused by cervical cancer.…”

“…Our preoperative diagnosis was endometrial cancer because we considered that the tumor occupied the uterine corpus and that there are a few case reports of primary SCC of the endometrium [ 15 ]. In addition, some case reports suggested that nonpuerperal uterine inversion was wrongly attributed to the cervical tumor in the preoperative diagnosis [ 11 , 12 ]. An accurate preoperative diagnosis is significant because the treatment of cervical cancer is different from other cancers.…”