Abstract:

Postmenopausal chronic uterine inversion is a rare disease. A case of uterine inversion caused by endometrial adenosarcoma in an elderly woman, complicating with infection, urinary retention and venous thromboembolism was reported. The patient was hospitalized due to postmenopausal vaginal bleeding. During that period, it was found that the tumor gradually prolapse from the vagina. After gynecologic physical examination and imaging examination, it was considered that the chronic complete uterine inversion secondary to the tumor in the fundus of the uterus. During the course of the disease, the patient developed infection, urinary retention and left lower extremity venous thromboembolism. After multi-disciplinary consultation, transabdominal perineum combined with hysterectomy and bilateral adnexa resection were finally performed under spinal canal anesthesia in our hospital. The postoperative pathology showed endometrial adenosarcoma and the clinical diagnosis was stage ⅠA. The patient refused to undergo re-staged surgery and adjuvant treatment. There was no new tumor found in 2 years follow-up. For this kind of rare disease, combined with the typical signs of ultrasound and pelvic MRI, the diagnosis can be made as soon as possible. The treatment should be aimed at the primary tumor, complications secondary to the inverted uterus and the patient′s own complications, to develop an individualized perioperative management scheme.

Key words: Intrauterine inversion, Postmenopause, Infection, Venous thrombosis, Endometrial neoplasms, Adenosarcoma, Case reports