NICOLAE BACALBASA, CASSIUS CIRLAN, IOAN SAS, IRINA BALESCU, MIHAI DIMITRIU1, MADALINA MARCU, MIHAELA MOLDOVAN, DANIEL PIRICI, ANDREI GHEORGHE MARIUS MOTOC, DAN BOGDAN NAVOLAN HEMOPERITONEUM FROM RUPTURED UTERINE TUMOR INVADING ILEAL MESENTERY AND MESOSIGMOID CASE REPORT AND LITERATURE REVIEW Uterine sarcomas are rare but very aggressive gynecologic malignancies. The most frequent signs and symptoms at the moment of diagnosis include abnormal uterine bleeding or diffuse abdomino-pelvic pains while acute abdomen by uterine rupture is an uncommon situation. We present the case of a 72 year old patient who presented in emergency for diffuse abdominal pain and hypotension. An emergency laparotomy was performed and a ruptured uterine tumor with small bowel and sigmoidian serosal invasion and intra-peritoneal bleeding was found. The tumor was resected en bloc with total hysterectomy, bilateral adnexectomy, segmental enterectomy and sigmoidectomy, pelvic and para-aortic lymph node dissection. The histopathological and immunohistochemistry examination revealed a poorly differentiated sarcoma. Although it is a rare condition, a uterine sarcoma can rupture and cause hemoperitoneum; emergency surgery while respecting oncologic principles of complete resection is mandatory.
Keywords: ruptured uterine tumor; uterine sarcoma; hemoperitoneum; radical surgery