An Atypical Presentation of Spontaneous Infarction of Uterus and Appendages

Spontaneous infarction of the uterus is an extremely rare condition with unknown etiology. Uterine fibroids are benign mesenchymal tumors and sometimes infarction can occur after uterine artery embolization or torsion in the fibroid. We report a delayed and neglected case of uterine fibroid, which caused spontaneous infarction of the whole uterus and its appendages in a 39-year-old unmarried woman. She was presented with severe pallor and dyspnea for which she was kept in the intensive care unit to stabilize her condition. The patient had a history of an abdominal mass for 10 years which was first diagnosed as fibroid of 7cm. The patient was planned for laparotomy, bilateral salpingo-oophorectomy, total abdominal hysterectomy and omentectomy. The intra-operative finding showed a huge infarcted uterine mass with congested and massively necrosed ovaries and tubes. Histopathological examination reported polyp presence in hemorrhagic infarction. Sections from mass, tubes and ovaries showed extensive hemorrhagic infarction with congested vessels. The patient was discharged satisfactorily with no post-operative complications. Keywords: Infarction; Uterus; Leiomyoma.