Nonpuerperal Uterine Inversion

A 57-year-old postmenopausal woman presented with acute- on-chronic vaginal bleeding.Pelvic examination revealed a vaginal mass extending from the cervix to the introitus.Pelvic MRI revealed uterine inversion secondary to an endometrial mass (Figure).Results from radical laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and bilateral lymph node dissection confirmed the MRI findings.Histopathologic findings demonstrated high-grade uterine adenosarcoma.Uterine inversion, a rare entity typically associated with childbirth, is characterized by uterine fundal inversion and descent through the cervix.Nonpuerperal uterine inversion is often associated with benign leiomyomas, but uterine malignancies occur in one-third of patients (1,2).The inverted uterine fundus within the vagina may cause clinical and radiologic diagnostic confusion and may be mistaken for a cervical or vaginal mass (2).