NON PUERPERAL INVERSION OF THE UTERUS IN A TEENAGER

We present here a case of a 14 year old Saudi unmarried school girl wh o was referred to our hospital because of menorrhagia of eight months duration, which did not respond to the combined oral contraceptive pil l. An ultrasound scan showed a small intramural fibroid which was thou ght to be too small to cause the menorrhagia. However, she contined to bleed per vaginam and her hemoglobin dropped by about 5 gms despite a n apparently normal examination under anaesthesia and diagnostic curet tage. A laparotomy was performed which revealed an inverted uterus whi le a fowl smelling mass was seen protruding from the internal cervical os. The mass was peeled off digitally and the uterus replaced using t he Haultins method. The histopathological report was a Rhabdomyosarcom a of the uterus. The patient was referred to an Oncology center where she had radical surgery and chemotherapy but she later died as a resul t of distant metastases.