Non puerperal uterine inversion caused by an adenosarcoma: A Case Report.

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Published Feb 18, 2024
https://doi.org/10.62438/tunismed.v102i2.4352
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Vol. 102 No. 2 (2024): Tunis med feb 2024

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Cyrine Belghith
Department A of Gynecology and Obstetrics, Charles Nicolle University Hospital of Tunis,University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, Tunis, Tunisia.
Ghada Abdelmoula
Department A of Gynecology and Obstetrics,Charles Nicolle University Hospital of Tunis,Tunis, University ‎ of ‎ Sousse, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Sousse, ‎ Sousse, Tunisia.
https://orcid.org/0000-0003-0540-4111
Mariem Garci
Department A of Gynecology and Obstetrics, Charles Nicolle University Hospital of Tunis,University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, Tunis, Tunisia.
Zeineb Ghali
Department A of Gynecology and Obstetrics, Charles Nicolle University Hospital of Tunis,University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, Tunis, Tunisia.
Saoussam Armi
Department of Gynecology and Obstetrics, Regional Hospital of Kasserine, University ‎ of ‎ Sousse, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Sousse, ‎ Sousse, Tunisia.
Mehdi Makni
Department A of Gynecology and Obstetrics, Charles Nicolle University Hospital of Tunis,University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, Tunis, Tunisia.
Fatma Dhieb
Department of Radiology, Charles Nicolle University hospital, University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, ‎Tunis, Tunisia
Miriam Boumediene
Department of Radiology, Charles Nicolle University hospital, University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, ‎Tunis, Tunisia
Myriam Jrad
Department of Radiology, Charles Nicolle University hospital, University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, ‎Tunis, Tunisia
Nabil Mathlouthi
Department A of Gynecology and Obstetrics, Charles Nicolle University Hospital of Tunis,University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, Tunis, Tunisia.
Olfa Slimani
Department A of Gynecology and Obstetrics, Charles Nicolle University Hospital of Tunis,University of Tunis El Manar, ‎ Faculty ‎ of ‎ Medicine ‎ of ‎ Tunis, Tunis, Tunisia.

Abstract

Introduction: Eighty-five per cent of uterine inversions are puerperal. Non-puerperal uterine inversion is usually caused by tumours that exert a traction force on the fundus of the uterus. This causes the uterus to be partially or completely inverted. It is commonly related to benign tumours like submucosal leiomyomas. Nevertheless, malignancies are an infrequent association.


Case presentation: We report a case of a 35-year-old female patient, medically and surgically free, gravida0 para0, complaining of menometrorrhagia associated with pelvic pain for 2 years. A suprapubic ultrasound scan showed an enlarged, globular uterus with a heterogeneous, undefined mass of 49 mm in size. MRI scan showed the appearance of a U-shaped uterine cavity and a thickened inverted uterine fundus with an endometrial infiltrating mass of 25 mm. Intraoperative exploration showed uterine inversion involving the ovaries; the fallopian tubes and the round ligaments and a necrotic intracavitary mass. The malignancy of the tumor was confirmed through anatomopathological examination as Adenosarcoma.


Conclusions: Uterine inversion is rare outside the puerperal period, and malignant etiology must not be overlooked. Therefore, comprehensive care with meticulous etiological investigation is crucial.

Keywords:

Uterine Inversion, Non puerperal, Adenosarcoma , Case report

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References

  1. Benjelloun AT, Makayssi A, Ennachit S, Elkarroumi M. Inversion utérine non puerpérale chronique: à propos d’un cas [Chronic non-puerperal uterine inversion: about a case]. Pan Afr Med J. 2018 Dec 13;31:231. French. doi: 10.11604/pamj.2018.31.231.16668. PMID: 31447988; PMCID: PMC6691321.
  2. Herath RP, Patabendige M, Rashid M, Wijesinghe PS. Nonpuerperal Uterine Inversion: What the Gynaecologists Need to Know? Obstet Gynecol Int. 2020 Jun 1;2020:8625186. doi: 10.1155/2020/8625186. PMID: 32565821; PMCID: PMC7285247.
  3. Gross RC, McGahan JP. Sonographic detection of partial uterine inversion. AJR Am J Roentgenol. 1985 Apr;144(4):761-2. doi: 10.2214/ajr.144.4.761. PMID: 3883711.
  4. Rana KA, Patel PS. Complete uterine inversion: an unusual yet crucial sonographic diagnosis. J Ultrasound Med. 2009 Dec;28(12):1719-22. doi: 10.7863/jum.2009.28.12.1719. PMID: 19933488.
  5. Wendel MP, Shnaekel KL, Magann EF. Uterine Inversion: A Review of a Life-Threatening Obstetrical Emergency. Obstet Gynecol Surv. 2018 Jul;73(7):411-417. doi: 10.1097/OGX.0000000000000580. PMID: 30062382.
  6. Lupovitch A, England ER, Chen R. Non-puerperal uterine inversion in association with uterine sarcoma: case report in a 26-year-old and review of the literature. Gynecol Oncol. 2005 Jun;97(3):938-41. doi: 10.1016/j.ygyno.2005.02.024. PMID: 15885762.
  7. Pelissier-Komorek A, Lucereau-Barbier M, Diab J, Gavillon N, Graesslin O. Inversion utérine non puerpérale aiguë du 3(e) degré [Acute non-puerperal uterine inversion the third degree]. Gynecol Obstet Fertil. 2013 Feb;41(2):130-2. French. doi: 10.1016/j.gyobfe.2012.12.006. Epub 2013 Jan 29. PMID: 23375988.
  8. Benson C, Miah AB. Uterine sarcoma - current perspectives. Int J Womens Health. 2017 Aug 31;9:597-606. doi: 10.2147/IJWH.S117754. PMID: 28919822; PMCID: PMC5587218.
  9. Nathenson MJ, Ravi V, Fleming N, Wang WL, Conley A. Uterine Adenosarcoma: a Review. Curr Oncol Rep. 2016 Nov;18(11):68. doi: 10.1007/s11912-016-0552-7. PMID: 27718181.
  10. Sassi S, Hamdane MM, Sellami Dhouib R, Doghri R, Mrad K, Kacem D, Ben Romdhane K. A propos d'une tumeur uterine rare chez une jeune de 17 ans [A rare uterine tumor in a 17 year-old girl]. Tunis Med. 2012 Jan;90(1):88-90. French. PMID: 22311458