TITLE:
Non-Puerperal Uterine Inversion with Uterine Mülleroblastoma in a Teenager: A Case Report of Loandjili General Hospital Pointe-Noire (Republic of Congo)
AUTHORS:
L. M. E. Eouani, J. C. Mokoko, Ngatali Sidney, A. Emeka Pognabeka, C. Itoua, L. H. Iloki
KEYWORDS:
Metrorrhagia, Swelling, Uterine Inversion, Medulloblastoma
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.5,
May
13,
2020
ABSTRACT: Introduction: Uterine inversion is a reversal of the uterus into a glove. It is an
obstetric complication of deliverance. Uterine inversion out from pregnancy is
rare. The Müller duct is an embryonic tubular formation which will transform
into the vagina, uterus, and fallopian tubes. The mixed Müllerian malignant
tumor is a rare tumor to girl and woman in genital activity, which develops in
the uterus at the expense of vestige of the Müller channels. The association of
these two pathologies is rare. We report an observation of complicated uterine
inversion mulloblastoma to a teenager. Observation: A teenager of 15 years old, admitted for a vulvar tumor, which has
occurred about two months. Student in the first class of senior high school,
she has no medical history, and no particular surgery. She had her threat at
the age of 13, and has a regular menstrual cycle of 30 days, with 05 days of
period. Two months before her admission, the patient noticed during her
menstruation, the perception of soft intravaginal tissue but which disappeared
when her period stopped. A week before her admission, she felt pelvic pain with
expulsive colic, radiating to the external genitals, 3 days later, a protusion
from the vaginal vestibule of a mass, so the volume gradually increased. It is
in front of this situation that the patient consults a health center, which refers
her to us for treatment. On admission, the patient was conscious with a good
hemodynamic state. Vulva inspection revealed a large, rounded mass with an endovaginal
implantation, with necrosis areas. This mass was resistant, bleeding in any
manipulation, mobile, perceive neither the cervical relief nor the presence of
the uterus. The ultrasound assessment had marked: a large abdomino-pelvic
pseudo-mass with urinary repercussions right form of hydronephrosis uretero and
associated with gastric distension, and MRI complete inversion of the uterus,
with the uterine in the vaginal cavity associated with a large vulvovaginal
mass. An apathetic examination of the specimen had made it possible to diagnose
a botryoid sarcoma that affects the cervix and uterine body (Mullerian tumor). Laparotomy
had revealed uterine inversion. This required a total hysterectomy with
appendectectomy had been performed. Then
the patient was transferred to the cancer service for treatment where in the
seventh day, she died in the surgery post.