Uterine carcinosarcoma due to foreign body (migrated intrauterine device): an extremely rare etiology of gynecological neoplasm
Uterine carcinosarcomas are extremely rare gynecological neoplasms. The coexistence of intraabdominal foreign bodies, such as migrated IUDs, and uterine neoplasms, particularly carcinosarcomas, represents a significant clinical challenge and infrequent association. Chronic inflammation associated with foreign bodies can act as a cofactor in carcinogenesis and explain the appearance of these tumors. A 65-year-old woman with a history of cesarean section, presented to the emergency department with a 5-day complaint of abdominal pain, nausea and constipation. An abdominal CT scan was performed, revealing a left parauterine mass containing a migrated intrauterine device (Lippes's loop) with a transition zone in the sigmoid colon. The patient was taken to exploratory laparotomy, where a subtotal hysterectomy and left salpingo-oophorectomy were performed. Pathology report showed uterine carcinosarcoma. This case exemplifies a rare clinical presentation of uterine neoplasm secondary to the presence of a foreign body (Lippes's loop), debuting with bowel obstruction. Uterine neoplasm secondary to foreign bodies are very rare clinical entities, and its pathophysiological mechanisms have not been fully understood. Particularly, uterine carcinosarcomas are a subgroup of these malignancies with a more aggressive behavior and poor oncological prognosis. Early diagnosis and prompt surgical management are the cornerstones of management.
