Unexpected Pathology: Abnormal Appearance of the Uterus

Unexpected large uteri are common; they are often due to fibroids, the incidence of which is up to 25% of all women. All patients should have a menstrual history taken and a pregnancy test performed before any operation, particularly if intrauterine instrumentation is planned. A biopsy can certainly be useful for diagnosing conditions such as adenomyosis, uterine sarcoma, or endometrial cancer. An abnormal serosal or indeed any peritoneal surface could be due to primary peritoneal cancer (very rare), secondary peritoneal cancer (particularly from the ovary), borderline tumors of the ovary, pseudomyxoma peritonei, peritoneal mesothelioma, tuberculosis, pelvic inflammatory disease, endometriosis, and other causes. In addition to a full clinical history, all patients should have either an abdominopelvic examination or pelvic ultrasound scan. Every female patient of reproductive age should have menstrual history taken and a pregnancy test performed on the day of or the day before the operation.