A Case Report Of Uterine Sarcoma

Abstract

A 71 year old female belonging to socio economic class 4 who is a P2L2A1/ previous 2 NVD/ ST done/ postmenopausal 20 years ago, k/c/o T2DM on regular treatment (OHA), k/c/o bronchial asthma on symptomatic treatment, Came with c/o post menopausal bleeding x 2 days in December 2020 , soaked 2 pads/day for past 3 months on and off ,c/o breathlessness on and off + for one week . On examination vitals stable , P/A-Soft, bowel sounds +,Obese abdominal wall ,SPT scar + healthy, Non tender, No mass palpable. P/S cervix- could not be visualized. P/V Cervix high up, flushed with vagina Uterus size palpable upto 16 weeks B/L fornices free. Al investigations were done. MRI was done endometrium was found to be thickened (figure -1). Endometrial aspiration as OP procedure was tried twice but os was tightly closed. Hence planned for surgery after obtaining fitness from cardiologist, respiratory medicne and after explaining the risk and getting consent. Staging laparotomy -TAH with BSO done on 1/3/2021 under spinal anesthesia . Intraoperatively uterus was found to be 16 weeks in size. Cut section showed ?degenerated fibroid like mass (figure -2) and was sent for HPE. Report showed endometrial stromal sarcoma- high grade with staging T 1bNxMx (figure-3). Patient was referred to Aringar anna cancer institute karapettai for further management where regular follow up was advised.