Inferior epigastric origin of the uterine artery during uterine artery embolization

The uterine artery (UA) originates from the anterior branch of the internal iliac artery (IIA). Several variants within the IIA territory have been described. More distant sites of origin include the superior mesenteric, inferior mesenteric, and external iliac arteries. Specifically, origin from the external iliac artery is extremely rare and we are only aware of one reported case in the literature. Herein, we report a case of a 43-year-old woman who required UA embolization to control abnormal uterine bleeding secondary to cervical cancer that was refractory to medical management and palliative radiation. During the procedure, it was discovered that the left UA shared a common trunk with the left inferior epigastric artery and arose from the external iliac artery.