A challenging case of non-puerperal uterine inversion masquerading as cervical mass in a young female
Uterine inversion, also know as, uterine intussusception is defined as telescoping of fundus of the uterus through the uterine cavity, and is graded into four grades based in the inferior bowing of the fundus with respect to the cervical and/or vaginal introitus. It is a rare entity, with two distinct group, with respect to the inciting cause, puerperal and non-puerperal. Non-puerperal is rarer of the two and has an array of presentation, ranging from acute emergent life-threatening condition to a chronic pelvic mass with menstrual irregularities. Such diversified presentation along with non-specific findings on ultrasonography, causes a diagnostic dilemma. Magnetic resonance imaging (MRI) is the best imaging modality, not just to clinch the diagnosis, but also to access the possible cause of the inversion. Typical MRI findings include loss of normal convex fundal contour on sagittal images and target sign on axial images. Management is mostly hysterectomy, with conservative management reserved for young females with desire of future child bearing and underlying benign cause. In our case report we present a case with MRI findings of grade II uterine inversion and a fundal submucosal fibroid, who presented with chronic pelvic pain and irregular menses. The patient was conservatively managed.