Non-puerperal uterine inversion caused by malignant mixed mullerian sarcoma

Abstract

SUMMARYNon puerperal uterine inversions resulting from mixed mullerian uterine sarcoma are rare. We present a case of a postmenopausal woman with a large mixed mullerian tumour presenting as a huge abdominopelvic mass. It required a challenging surgical procedure to remove the tumour which is also described along with the review of literature. BACKGROUND

A 29-year-old female with nonpuerperal vaginal bleeding – Complete uterine inversion

“…However, 70%–80% of cases of nonpuerperal inversions are associated with benign or malignant uterine tumors. [ 2 3 4 5 6 ] Raised intra-abdominal pressure due to coughing, sneezing, and straining can further aggravate the inversion.…”

A Case of Nonpuerperal Uterine Inversion Caused by Cervical Cancer

“…While nonpuerperal uterine inversion is triggered by internal forces, puerperal uterine inversion is triggered by external forces, such as umbilical cord traction and manual removal of the placenta. Internal forces include sudden extrusion of a tumor from the uterus, thinning of the uterine wall, dilatation of the uterine cervix, tumor size, and thickness of the tumor pedicle and tumor attachment site [ 3 – 6 ]. These factors are intricately related and lead to uterine inversion.…”

Non-Puerperal Uterine Inversion

“…Non-puerperal uterine inversion may be idiopathic or associated with such predisposing factors as benign uterine tumors in 70–80 percent of cases (leiomyoma, endometrial polyps), or malignant tumor in the remaining, especially in young women (leiomyosarcoma, mixed Müllerian sarcoma, rhabdomyosarcoma, endometrial and cervical carcinoma) [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 ]. The degree of inversion may be classified into incomplete, complete, or total.…”