Case Report: Spontaneous perforation of a bicornuate uterus with concomitant sarcoma

F1000Res. 2020 Sep 16:9:1143. doi: 10.12688/f1000research.25961.2. eCollection 2020.

Abstract

A 47-year-old nulliparous, virginal woman presented to the emergency department with acute abdominal pain. Emergency pelvic ultrasound and abdominal CT were taken, which showed a significant amount of hemoperitoneum and a bicornuate uterus with about 18cm x 10cm mass on left uterus. Since the mass had increased vascularity and irregular margins, we thought that the mass could be a uterine sarcoma. MRI and PET/CT were taken additionally for oncologic evaluation before surgery. Intra operative 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. She was treated with 6 cycles of chemotherapy(etoposide, ifosfamide, cisplatin) postoperatively. Chest and abdomen CT for follow up after chemotherapy showed no sign of cancer recurrence. We suggest a bicornuate uterus with concomitant sarcoma should be concerned as a possible cause of uterine rupture by reviewing this case.

Keywords: Bicornuate uterus; Uterine rupture; Uterine sarcoma.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Positron Emission Tomography Computed Tomography
  • Pregnancy
  • Sarcoma* / complications
  • Spontaneous Perforation*
  • Uterus

Grants and funding

The author(s) declared that no grants were involved in supporting this work.