CLINICAL HISTORY: A 58 years old postmenopausal woman with hypertension (under treatment) and diabetes mellitus (first diagnosed during the preoperative lab workup). she is postmenopausal 11years . she complained of postmenopausal bleeding (1st attack). by clinical exam the uterus was of normal size AVF with no focal masses, both adnexa were not palpable on bimanual examination. cervix and vagina were clinically free. EUA and endometrial aspiration biopsy was performed useing MVA. The endometrial sample was cpious, and sent for histopathology. Four dayes later the pathology report revealed mixed mullerian tumor (carcino-sarcoma), the patient was prepared medically and undergone TAH+BSO. The specimen was sent to tle pathologist wo confirmed the 1st diagnosis of sarcoma and added that the sarcomatous mass was in the posterior uterine wall away from the cervix and invading the superficial layer of the endometrium. Post operative total pelvic irradiation was decided.
here are the photos of the uterus
