Uterine Leiomyosarcoma in a Young Woman: A Report of a Rare Case.

Uterine leiomyosarcoma (LMS) is an uncommon disease that arises from the smooth muscles present in the uterus. It usually occurs in post-menopausal women. Due to its aggressive nature, it has a very poor prognosis. We present a case of uterine LMS, which presented at a young age of 35 years for infertility, which is rare at this age. She had a fundal fibroid for which myomectomy was done. On histopathology, she was diagnosed with LMS. It is very difficult and nearly impossible to diagnose LMS preoperatively by available imaging modalities. There is an urgent need for a reliable preoperative risk scoring system that can help in diagnosing malignancy so that a correct surgical pathway and treatment can be offered to patients. A total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) was done and was advised adjuvant chemotherapy. The patient remained disease-free and was put on chemotherapy.

Imperforate Hymen: A Report of a Case With Classical Signs.

An imperforate hymen (IH) is a condition where the hymen, which is a thin membrane that partially covers the vaginal opening, completely obstructs the vaginal canal. This condition is associated with problems such as pelvic mass, cyclical abdominal discomfort, and difficulty in urination. The occurrence of IH is quite rare, with an incidence of only one in 1000-10,000 women worldwide. We discuss a classical case of primary amenorrhoea with associated complaints of urinary retention and its management by hymenotomy (cruciate incision). We also considered the risk of hymen re-closure due to the lack of estrogenization of genital tissue and offered the patient the option of vaginal molding.

Uterine Artery Embolisation: A Saviour for Central Placenta Previa.

Central placenta previa is generally managed by caesarean section, uterotonic drugs, hemostatic sutures, and hemostatic balloon tamponade, and it usually ends in peripartum hysterectomy, with an incidence of 4% along with an increased incidence of maternal and neonatal morbidity or mortality. Selective uterine artery embolization (UAE) helps to prevent these complications while preserving future fertility. A 32-year-old patient was diagnosed as a case of a previous section with central placenta previa with accreta at 38 weeks and was planned for an elective caesarean section. A prophylactic selective bilateral internal iliac artery cannulation under sonographic guidance and subsequent cannulation and embolisation of bilateral uterine arteries under fluoroscopic guidance was done. It reduced the massive blood transfusions and operative time, preserved fertility without any maternal or foetal morbidity or mortality, and no other complications were reported.