Severe Hemoperitoneum: Spontaneous Rupture of Uterine Leiomyosarcoma: A Rare Case

Uterine sarcomas, unlike the more prevalent leiomyomas, are not common. leiomyosarcoma tends to exhibit aggressive behavior and is associated with a worse prognosis. Leiomyomas are notably linked to uterine rupture with hemoperitoneum. Here, we present a rare case of spontaneous rupture of uterine leiomyosarcoma. A 44-year-old woman with multiple childbirths reported abdominal pain. A clinical examination indicated a large abdominal mass. After active resuscitation, Computed Tomography (CT) revealed an accumulation of intraperitoneal fluid and a heterogeneous mass in the uterus. The patient underwent emergency laparotomy and total hysterectomy due to a ruptured leiomyoma. The final pathology confirmed the diagnosis of leiomyosarcoma. Bleeding was a result of infarction and ulceration or ruptured superficial veins caused by elevated intra-abdominal pressure. Spontaneous hemorrhage from a uterine leiomyosarcoma leading to hemoperitoneum is rare. This condition should be considered in the differential diagnosis of gynecological emergencies.