Abstract
A 47-year-old nulliparous, virginal woman presented to the emergency department with acute abdominal pain. Emergency pelvic ultrasonography and abdominal CT were taken, which showed a significant amount of hemoperitoneum and a bicornuate uterus with about 18cm x 10cm mass on the left uterus. Since the mass had increased vascularity and irregular margins, we thought that the mass could be a uterine sarcoma. Pelvic MRI and PET/CT were taken additionally for oncologic evaluation before surgery. Intraoperative findings showed a ruptured bicornuate uterus with a large mass within the left uterine horn. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathologic analysis confirmed an undifferentiated uterine sarcoma. Therefore, we report a case of spontaneous rupture of bicornuate uterus with concomitant sarcoma occurred in a 47-year-old woman.
Highlights
Spontaneous uterine rupture occurs most commonly with labor and delivery[1]
Pelvic magnetic resonance imaging (MRI) was performed on the day after the patient’s initial presentation, revealed underlying uterus didelphys with an approximately 15- × 9- × 17-cm mass with mixed signal intensity in the lower abdominal area (Figure 2) and an approximately 6- × 2.7- × 3-cm mass of the left cervix and lower uterine body on T2-weighted imaging. These MRI findings suggested the possibility of hemoperitoneum or cancer peritonei due to rupture of (1) endometrial cancer, (2) uterine sarcoma, or (3) large myoma with degeneration
Higher rates of uterine rupture have been reported in patients with Müllerian duct abnormalities who elect to undergo a trial of labor after cesarean delivery when compared with patients without Müllerian duct abnormalities, suggesting that these anomalies may be an independent risk factor for uterine rupture[5]
Summary
Spontaneous uterine rupture occurs most commonly with labor and delivery[1]. When it does occur, the most common cause of rupture is dehiscence of a previous transmyometrial surgical incision, such as that from a cesarean section scar[2]. Pelvic MRI was performed on the day after the patient’s initial presentation, revealed underlying uterus didelphys with an approximately 15- × 9- × 17-cm mass with mixed signal intensity in the lower abdominal area (Figure 2) and an approximately 6- × 2.7- × 3-cm mass of the left cervix and lower uterine body on T2-weighted imaging. These MRI findings suggested the possibility of hemoperitoneum or cancer peritonei due to rupture of (1) endometrial cancer, (2) uterine sarcoma, or (3) large myoma with degeneration. There were no sign of cancer recurrence in the chest and abdominal CT
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
