Uterine inversions of tumor origin in two cases at the Joliot Curie Institute at the Aristide Le Dantec University Hospital Center

Uterine inversions of tumor origin in two cases at the Joliot Curie Institute at the Aristide Le Dantec University Hospital Center | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case report Uterine inversions of tumor origin in two cases at the Joliot Curie Institute at the Aristide Le Dantec University Hospital Center SIDY KA, ABDOULAYE DIAKHATÉ, DABA DIOP, ROLAND OLLO SOME, ADJA COUMBA DIALLO, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-51661/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction non-puerperal uterine inversions are a rare situation. Indeed, 85% of uterine inversions are puerperal. We report 2 cases observed at the Joliot Curie Institute of the Aristide Le Dantec University Hospital. Case Presentation It was about a 39-year-old primigravida and a 47-year-old seventh gestational patient, who had a stage 4 of uterine inversion picture in relation to uterine sarcoma and uterine myoma respectively. The diagnosis was suspected at the clinic due to the absence of palpation of the uterus. Confirmation was made on medical imaging and intraoperatively. Management was radical with a total hysterectomy with bilateral adnexectomy via the vaginal and abdominal routes. However, in the first patient with sarcoma, surgery combined bilateral pelvic lymphadenectomy and was preceded by chemotherapy. Conclusion non-puerperal uterine inversion is a rare situation. Its treatment is essentially surgical. However, it is important to look for an etiology and in the case of a tumor to ensure that the mass is a cancer or not because the management and prognosis depend on it. Surgery Oncology uterine inversion uterine sarcoma vaginal mass Figures Figure 1 Figure 2 Introduction Non-puerperal uterine inversion is an uncommun disease [1]. Indeed, 85% of uterine inversions have puerperal origin [2]. Depending on the severity, four degrees can be distinguished [2]: first degree: the uterine fundus is depressed in a "vial bottom" or cup; second stage: the uterus is inverted and passes through the external cervical opening; third degree: the uterine body becomes intravaginal and can completely externalize; fourth degree or total inversion: the vaginal walls participate in the inversion. We report 2 cases of uterine inversion with tumoral origin observed at the Joliot Curie Institute in Dakar. Case Presentation Case 1 It was about a primigravida, primiparous 39 years old woman, without particular pathological background, who had consulted for hydrorrhea. The clinical examination had found a good general status, an abdominal and pelvic mass going up two fingertips above the umbilicus. The vulva was soiled with serum with the presence of a necrotic mass developed at the expense of the uterus. Histological examination of a biopsy specimen was in favor of a sarcomatous tumor. Abdominal and pelvic ultrasonography had found a uterine mass that measured 112mm x 83mm x 78mm with no impact on the upper urinary tract. The thoracic and abdominal pelvic CT found an uterine tumor prolapsing in the vagina infiltrating the anterior surface of the rectum and pushing the bladder back without any obvious sign of invasion and without any distant metastasis. Pelvic MRI found a cervical tumor extending to the posterior myometrium. The diagnosis of uterine sarcoma invading the lower 1/3 of the vagina was retained. After tumor board discussion, chemotherapy was administered without clinical response, followed by surgery including abdominal pelvic lymphadenectomy and bilateral adnexectomy followed by vaginal hysterectomy (Figure 1). At 5 months follow up there was no particularities. Case 2 This was a 47 years old woman seventh gesture with no particular disease background, who had consulted for abdominal and pelvic pain and metrorrhagia. Clinical examination revealed a third-degree uterine inversion with a mass appended to the uterine fundus (figure 2A). Histology of the biopsy specimen was in favor of a fleshy bud. At the pelvic ultrasound, the uterus was not visualized. We found a rounded anechoic image with sharp storytellers, located behind the, 5 cm long. The diagnosis of a type 4 uterine inversion associated with an ovarian cyst was made. Management included a hysterectomy with bilateral adnexectomy in two stages. A stage of abdominal approach with control of ovaries which are aspirated through the inverted uterine hole and a stage of vaginal approach (Figure 2B). Surgical suites were without any complications. Histological examination of the surgical specimen showed a uterine leiomyoma. Discussion Uterine inversion is defined as an invagination of the uterine fundus like a "glove finger". It is an exceptional clinical situation, especially outside the puerperal period [ 3 ]. Between 1976 and 2014, only fifty-six cases have been recorded in the literature and mainly concerned menopausal women or women over 45 years of age [ 4 ]. In our series, we had one patient aged 47 and one aged 39. The diagnosis is made clinically in patients with advanced stages of uterine inversion. It is more precise in intraoperative period [ 2 ]. Several factors are involved in the physiopathology of non-puerperal uterine inversion: uterine tumor located preferentially on the uterine fundus, thin uterine wall, uterine tumors with small pedicle, rapid tumor growth and wide opening cervix [ 2 ]. In fact, submucosal myoma is the most found etiology counting for 70 to 85% of cases against 15 to 30% for malignant factors. Between them sarcomas are the most frequent [ 5 ]. Hysterectomy remains the preferred treatment and/or in case of 3rd or 4th degree uterine inversion [ 2 ]. It can be performed vaginally [ 3 , 6 ] after careful repositioning of the uterus in its anatomical position [ 4 ]. Which is impossible for fixed and malignant lesions for which carcinologic rules such are resection margins and extensive surgery are essential. A laparoscopy-vaginal route association has also been described by some authors such as Auber et al [ 7 ] and Komorek et al [ 2 ]. Conclusion Non-puerperal uterine inversion is a rare situation. Its treatment is essentially surgical. However, it is important to look for an etiology and in the case of a tumor to ensure that the mass is a cancer or not because the management and prognosis depend on it. Declarations Conflicts of interest : none Informed consent write informed consent was obtained from the patients for their anonymized information to be published in this article Ethics approval and consent to participate Patients confidentiality is protected according to our local institutional ethic committee board considerations: “Comité d’éthique institutionnel du département de chirurgie et spécialités” No CEI-DPT-CHIR-2020-006 / August 1st 2020 “retrospectively”. Consent for publication Patients were informed that data concerning the case would be submitted for publication. They agreed to this. The study followed our hospital investigation guidelines. Availability of data and material our data are available in the archives of the “Institut Joliot Curie” of teaching hospital of Aristide Le Dantec. The datas used during the current study are available from the corresponding author on reasonable request. We authorize the editorial team of World Journal of Surgical Oncology to publish them according to the international rules in force. Competing interests: None declared Funding: None Authors' contributions Dr S. KA made the study design and write the paper. All authors were involved in the patient’s management: Dr S. KA, A. DIAKHATÉ, D. DIOP for diagnostic; Dr S. KA, A. DIAKHATÉ, D. DIOP, OR SOME, for surgery; A.K. DIALLO, M BAH for anatomopathological studies; A. DEM for patients’ evaluation and checking the draft of manuscript. They all reviewed and approved the paper. Acknowledgments The authors would like to thank the team of gynaecology department of Teaching hospital of Aritide Le Dantec for his contribution in management of the patient. References -Das. Inversion of the uterus. J Gynaecology Br Emp. 1940;47:525–48. -Pelissier-Komorek A, Lucereau-Barbier M, Diab J. Inversion uterine non puerperale aigue du 3ème degré. Gynécologie Obstétrique et Fértilité. 2013;41:130–2. -Atalay M, Demir B, Solak N. An unusual presentation of a submucous leiomyoma accounting to a non-puerperal uterine inversion: a case report. J Turkish Ger Gynecol Assoc. 2013;14(2):116–8. -Lupovitch A, England ER, Chen R. Non puerperal uterine inversion in association with uterine sarcoma: Case report in a 26-year-old and review of the literature. Gynecol Oncol. 2005;97:938–41. -Kopal S, Seckin N, Turhan N. Acute uterine inversion due to a growing submucous myoma in an elderly woman: case report. Eur J Obstet Gynecol Reprod Biol. 2001;99:118–20. -Tuckett J, Yeung A, Timmons G. Non puerperal uterine inversion secondary to uterine sarcoma and ascites demonstrated on CT and MRI. Eur J Radiol Extra Elsevier Ireland Ltd. 2010;75(3):119–23. -Auber M, Darwish B, Lefebure A. Management of non puerperal uterine nversion using a combined laparoscopic and vaginal approach. Am J Obstet Gynecol. 2011;204:7–9. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-51661","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case report","associatedPublications":[],"authors":[{"id":2389214,"identity":"2df05bdc-6b96-4bf0-8c90-ff9e98cd8d2b","order_by":0,"name":"SIDY KA","email":"","orcid":"","institution":"Hopital Aristide Le Dantec","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"SIDY","middleName":"","lastName":"KA","suffix":""},{"id":2389215,"identity":"73119f79-03ae-422e-8cdb-4efe12696cb6","order_by":1,"name":"ABDOULAYE DIAKHATÉ","email":"","orcid":"","institution":"Hopital Aristide Le Dantec","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"ABDOULAYE","middleName":"","lastName":"DIAKHATÉ","suffix":""},{"id":2389216,"identity":"a44cf44c-c5fd-414b-90c3-665a4bd62763","order_by":2,"name":"DABA DIOP","email":"","orcid":"","institution":"Hopital Aristide Le Dantec","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"DABA","middleName":"","lastName":"DIOP","suffix":""},{"id":2389217,"identity":"1c2f13c9-9092-4fbf-aa91-ee224f6dae27","order_by":3,"name":"ROLAND OLLO SOME","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAvUlEQVRIiWNgGAWjYPACCxl+BgY2EIufWC0SPJINEC1AmlgtBgeI1SLf3p3AXFEhwWN8I/nZgw8VDBLmhPQYnDm7gfHMGQkesxtp5oYzzjBIyBwgpEUidwNjYxtIS4KZNG8bQ50EQYfNgGoxnpH+DaRFgqAWhhtQLQYSOWbEaQH7pQHoF4kzb8okZ5yRIKxFvr0XqKXCRo6/PX2bxIcKGyIcxsDA/gNMCSSASGI0wAH/AVJUj4JRMApGwUgCANtZNY0WV2tFAAAAAElFTkSuQmCC","orcid":"","institution":"Souro Sano teaching hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"ROLAND","middleName":"OLLO","lastName":"SOME","suffix":""},{"id":2389218,"identity":"c67f2f15-d5c3-43d0-929c-3b218816f9c7","order_by":4,"name":"ADJA COUMBA DIALLO","email":"","orcid":"","institution":"Hopital Aristide Le Dantec","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"ADJA","middleName":"COUMBA","lastName":"DIALLO","suffix":""},{"id":2389219,"identity":"e7d50971-b6e1-40dc-9814-0a7dd131685e","order_by":5,"name":"MALICK BAH","email":"","orcid":"","institution":"Hopital Aristide Le Dantec","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"MALICK","middleName":"","lastName":"BAH","suffix":""},{"id":2389220,"identity":"9794acb6-6651-407c-ab2b-14df7876387d","order_by":6,"name":"AHMADOU DEM","email":"","orcid":"","institution":"Hopital Aristide Le Dantec","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"AHMADOU","middleName":"","lastName":"DEM","suffix":""}],"badges":[],"createdAt":"2020-07-31 10:32:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-51661/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-51661/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":2457656,"identity":"e4e8eb0e-198c-4ca6-8574-7de56b8f933b","added_by":"auto","created_at":"2020-09-17 16:13:18","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":70808,"visible":true,"origin":"","legend":"Post-operative specimen of a sarcoma of an inverted uterus","description":"","filename":"Fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-51661/v1/Fig1.jpg"},{"id":2457657,"identity":"f7ba3d18-672e-4146-bff4-ca6da25557c7","added_by":"auto","created_at":"2020-09-17 16:13:19","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":90505,"visible":true,"origin":"","legend":"Macroscopic aspect: Perineal view (A); Abdominal operative view (B)","description":"","filename":"Fig2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-51661/v1/Fig2.jpg"},{"id":13593934,"identity":"23454495-90a3-4c36-88f2-0599c14f5a62","added_by":"auto","created_at":"2021-09-17 05:18:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":300331,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-51661/v1/3302895c-f5bc-4c42-935f-26d252d1d954.pdf"}],"financialInterests":"","formattedTitle":"Uterine inversions of tumor origin in two cases at the Joliot Curie Institute at the Aristide Le Dantec University Hospital Center","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNon-puerperal uterine inversion is an uncommun disease [1]. Indeed, 85% of uterine inversions have puerperal origin [2].\u003c/p\u003e\n\u003cp\u003eDepending on the severity, four degrees can be distinguished [2]:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003efirst degree: the uterine fundus is depressed in a \"vial bottom\" or cup;\u003c/li\u003e\n\u003cli\u003esecond stage: the uterus is inverted and passes through the external cervical opening;\u003c/li\u003e\n\u003cli\u003ethird degree: the uterine body becomes intravaginal and can completely externalize;\u003c/li\u003e\n\u003cli\u003efourth degree or total inversion: the vaginal walls participate in the inversion.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eWe report 2 cases of uterine inversion with tumoral origin observed at the Joliot Curie Institute in Dakar.\u003c/p\u003e "},{"header":"Case Presentation","content":"\u003cp\u003e\u003cstrong\u003eCase 1\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIt was about a primigravida, primiparous 39 years old woman, without particular pathological background, who had consulted for hydrorrhea.\u003c/p\u003e\n\u003cp\u003eThe clinical examination had found a good general status, an abdominal and pelvic mass going up two fingertips above the umbilicus. The vulva was soiled with serum with the presence of a necrotic mass developed at the expense of the uterus.\u003c/p\u003e\n\u003cp\u003eHistological examination of a biopsy specimen was in favor of a sarcomatous tumor.\u003c/p\u003e\n\u003cp\u003eAbdominal and pelvic ultrasonography had found a uterine mass that measured 112mm x 83mm x 78mm with no impact on the upper urinary tract.\u003c/p\u003e\n\u003cp\u003eThe thoracic and abdominal pelvic CT found an uterine tumor prolapsing in the vagina infiltrating the anterior surface of the rectum and pushing the bladder back without any obvious sign of invasion and without any distant metastasis.\u003c/p\u003e\n\u003cp\u003ePelvic MRI found a cervical tumor extending to the posterior myometrium.\u003c/p\u003e\n\u003cp\u003eThe diagnosis of uterine sarcoma invading the lower 1/3 of the vagina was retained. After tumor board discussion, chemotherapy was administered without clinical response, followed by surgery including abdominal pelvic lymphadenectomy and bilateral adnexectomy followed by vaginal hysterectomy (Figure 1). At 5 months follow up there was no particularities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase 2\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis was a 47 years old woman seventh gesture with no particular disease background, who had consulted for abdominal and pelvic pain and metrorrhagia.\u003c/p\u003e\n\u003cp\u003eClinical examination revealed a third-degree uterine inversion with a mass appended to the uterine fundus (figure 2A). Histology of the biopsy specimen was in favor of a fleshy bud. At the pelvic ultrasound, the uterus was not visualized. We found a rounded anechoic image with sharp storytellers, located behind the, 5 cm long.\u003c/p\u003e\n\u003cp\u003eThe diagnosis of a type 4 uterine inversion associated with an ovarian cyst was made. Management included a hysterectomy with bilateral adnexectomy in two stages. A stage of abdominal approach with control of ovaries which are aspirated through the inverted uterine hole and a stage of vaginal approach (Figure 2B). Surgical suites were without any complications. Histological examination of the surgical specimen showed a uterine leiomyoma.\u003c/p\u003e"},{"header":"Discussion","content":" \u003cp\u003eUterine inversion is defined as an invagination of the uterine fundus like a \"glove finger\". It is an exceptional clinical situation, especially outside the puerperal period [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Between 1976 and 2014, only fifty-six cases have been recorded in the literature and mainly concerned menopausal women or women over 45\u0026nbsp;years of age [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In our series, we had one patient aged 47 and one aged 39.\u003c/p\u003e \u003cp\u003eThe diagnosis is made clinically in patients with advanced stages of uterine inversion. It is more precise in intraoperative period [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral factors are involved in the physiopathology of non-puerperal uterine inversion: uterine tumor located preferentially on the uterine fundus, thin uterine wall, uterine tumors with small pedicle, rapid tumor growth and wide opening cervix [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In fact, submucosal myoma is the most found etiology counting for 70 to 85% of cases against 15 to 30% for malignant factors. Between them sarcomas are the most frequent [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHysterectomy remains the preferred treatment and/or in case of 3rd or 4th degree uterine inversion [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. It can be performed vaginally [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] after careful repositioning of the uterus in its anatomical position [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Which is impossible for fixed and malignant lesions for which carcinologic rules such are resection margins and extensive surgery are essential. A laparoscopy-vaginal route association has also been described by some authors such as Auber et al [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] and Komorek et al [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e "},{"header":"Conclusion","content":" \u003cp\u003eNon-puerperal uterine inversion is a rare situation. Its treatment is essentially surgical. However, it is important to look for an etiology and in the case of a tumor to ensure that the mass is a cancer or not because the management and prognosis depend on it.\u003c/p\u003e "},{"header":"Declarations","content":" \u003cp\u003e \u003ch2\u003e\u003cem\u003eConflicts of interest\u003c/em\u003e:\u003c/h2\u003e \u003cp\u003enone\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eInformed consent\u003c/strong\u003e \u003cp\u003ewrite informed consent was obtained from the patients for their anonymized information to be published in this article\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003ePatients confidentiality is protected according to our local institutional ethic committee board considerations: \u0026ldquo;Comit\u0026eacute; d\u0026rsquo;\u0026eacute;thique institutionnel du d\u0026eacute;partement de chirurgie et sp\u0026eacute;cialit\u0026eacute;s\u0026rdquo; No CEI-DPT-CHIR-2020-006 / August 1st 2020 \u0026ldquo;retrospectively\u0026rdquo;.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003ePatients were informed that data concerning the case would be submitted for publication. They agreed to this. The study followed our hospital investigation guidelines.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eAvailability of data and material\u003c/strong\u003e \u003cp\u003eour data are available in the archives of the \u0026ldquo;Institut Joliot Curie\u0026rdquo; of teaching hospital of Aristide Le Dantec. The datas used during the current study are available from the corresponding author on reasonable request. We authorize the editorial team of World Journal of Surgical Oncology to publish them according to the international rules in force.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompeting interests:\u003c/strong\u003e \u003cp\u003eNone declared\u003c/p\u003e \u003c/p\u003e \u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eNone\u003c/p\u003e \u003ch2\u003eAuthors' contributions\u003c/h2\u003e \u003cp\u003eDr S. KA made the study design and write the paper. All authors were involved in the patient\u0026rsquo;s management: Dr S. KA, A. DIAKHAT\u0026Eacute;, D. DIOP for diagnostic; Dr S. KA, A. DIAKHAT\u0026Eacute;, D. DIOP, OR SOME, for surgery; A.K. DIALLO, M BAH for anatomopathological studies; A. DEM for patients\u0026rsquo; evaluation and checking the draft of manuscript. They all reviewed and approved the paper.\u003c/p\u003e \u003ch2\u003eAcknowledgments\u003c/h2\u003e \u003cp\u003eThe authors would like to thank the team of gynaecology department of Teaching hospital of Aritide Le Dantec for his contribution in management of the patient.\u003c/p\u003e "},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cspan\u003e-Das. Inversion of the uterus. J Gynaecology Br Emp. 1940;47:525\u0026ndash;48.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003e-Pelissier-Komorek A, Lucereau-Barbier M, Diab J. Inversion uterine non puerperale aigue du 3\u0026egrave;me degr\u0026eacute;. Gyn\u0026eacute;cologie Obst\u0026eacute;trique et F\u0026eacute;rtilit\u0026eacute;. 2013;41:130\u0026ndash;2.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003e-Atalay M, Demir B, Solak N. An unusual presentation of a submucous leiomyoma accounting to a non-puerperal uterine inversion: a case report. J Turkish Ger Gynecol Assoc. 2013;14(2):116\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003e-Lupovitch A, England ER, Chen R. Non puerperal uterine inversion in association with uterine sarcoma: Case report in a 26-year-old and review of the literature. Gynecol Oncol. 2005;97:938\u0026ndash;41.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003e-Kopal S, Seckin N, Turhan N. Acute uterine inversion due to a growing submucous myoma in an elderly woman: case report. Eur J Obstet Gynecol Reprod Biol. 2001;99:118\u0026ndash;20.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003e-Tuckett J, Yeung A, Timmons G. Non puerperal uterine inversion secondary to uterine sarcoma and ascites demonstrated on CT and MRI. Eur J Radiol Extra Elsevier Ireland Ltd. 2010;75(3):119\u0026ndash;23.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003e-Auber M, Darwish B, Lefebure A. Management of non puerperal uterine nversion using a combined laparoscopic and vaginal approach. Am J Obstet Gynecol. 2011;204:7\u0026ndash;9.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"uterine inversion, uterine sarcoma, vaginal mass","lastPublishedDoi":"10.21203/rs.3.rs-51661/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-51661/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIntroduction\u003c/p\u003e\u003cp\u003enon-puerperal uterine inversions are a rare situation. Indeed, 85% of uterine inversions are puerperal. We report 2 cases observed at the Joliot Curie Institute of the Aristide Le Dantec University Hospital.\u003c/p\u003e\u003cp\u003eCase Presentation\u003c/p\u003e\u003cp\u003eIt was about a 39-year-old primigravida and a 47-year-old seventh gestational patient, who had a stage 4 of uterine inversion picture in relation to uterine sarcoma and uterine myoma respectively. The diagnosis was suspected at the clinic due to the absence of palpation of the uterus. Confirmation was made on medical imaging and intraoperatively. Management was radical with a total hysterectomy with bilateral adnexectomy via the vaginal and abdominal routes. However, in the first patient with sarcoma, surgery combined bilateral pelvic lymphadenectomy and was preceded by chemotherapy.\u003c/p\u003e\u003cp\u003eConclusion\u003c/p\u003e\u003cp\u003enon-puerperal uterine inversion is a rare situation. Its treatment is essentially surgical. However, it is important to look for an etiology and in the case of a tumor to ensure that the mass is a cancer or not because the management and prognosis depend on it.\u003c/p\u003e","manuscriptTitle":"Uterine inversions of tumor origin in two cases at the Joliot Curie Institute at the Aristide Le Dantec University Hospital Center","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-09-17 16:13:16","doi":"10.21203/rs.3.rs-51661/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7c0aa098-f1f3-4f7e-ac32-1edd29794764","owner":[],"postedDate":"September 17th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":540507,"name":"Surgery"},{"id":540508,"name":"Oncology"}],"tags":[],"updatedAt":"2021-01-31T14:54:32+00:00","versionOfRecord":[],"versionCreatedAt":"2020-09-17 16:13:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-51661","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-51661","identity":"rs-51661","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}