Endometrial sarcoma with uterovaginal prolapse in a postmeno
Published in the Journal of Mid-life Health, the authors present a case of a postmenopausal female who presented with something coming out per vagina. The clinical impression was that of a third-degree uterovaginal prolapse that on histopathological examination was diagnosed as a low-grade ESS (Endometrial stromal sarcoma).

A 52-year-postmenopausal female reported with a complaint of something coming out per vagina since 16 years. She was para 4; with three normal vaginal deliveries and cesarean section for the last childbirth. She achieved menopause 1 year back, and there was no history of postmenopausal bleeding. She had menarche at the age of 14 years with regular cycles and normal flow.

On clinical examination, abdomen was soft, nontender, midline scar of previous cesarean section was seen, and no mass was felt. Local examination showed third-degree uterovaginal prolapse with third-degree cystocele and rectocele. Per vaginal examination revealed uterus approximately 8–10 weeks' size, anteverted, and bilateral adnexa free.

Her routine investigations along with papanicolaou smear were within normal limits. Transvaginal ultrasound scan suggested a diffusely bulky uterus with heterogeneous myometrium with subendometrial echogenic and acoustic shadows suggestive of adenomyosis. Endometrial thickness was 2.4 mm and bilateral adnexa was normal. The patient underwent vaginal hysterectomy with pelvic floor repairs. The specimen sent for histopathological examination.

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