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Uterine inversion associated with malignancy – A challenge in surgical management: A case report

Jehada-Inn U. Misuari-Alihuddin, MD, FPOGS and Maria Julieta V. Germar, MD, FPOGS, FSGOP
Department of Obstetrics and Gynecology, Philippine General Hospital, University of the Philippines-Manila

Uterine inversion is a rare clinical problem. Most cases of uterine inversions are puerperal inversions wherein it is encountered as an obstetric emergency, and sometimes a diagnostic challenge in gynecology. Uterine inversions associated with malignancies such as endometrial carcinoma and sarcoma are even rare. We report 2 cases of this rare condition. A 55 year old diagnosed with endometrial carcinoma and a 60-year-old woman diagnosed with sarcoma (malignant mixed mullerian tumor) presented with mass protruding from the vaginal introitus. The diagnosis of complete uterine inversion was confirmed in both cases during laparotomy. Total abdominal and vaginal hysterectomy and bilateral salpingo-oophorectomy, bilateral pelvic lymph node dissection, paraaortic lymph node sampling was done. It required a challenging surgical procedure to remove the tumor along with the review of literature especially of its association with malignancies.