IMR Press / CEOG / Volume 48 / Issue 1 / DOI: 10.31083/j.ceog.2021.01.2187
Open Access Case Report
Uterine leiomyosarcoma presenting as septic shock in a 43-year-old woman: a case report
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1 Fukushima Medical Center for Children and Women, Fukushima Medical University, 960-1295 Fukushima, Japan
2 Kameda MTG Clinic, 261-8501 Chiba, Japan
*Correspondence: (Toshifumi Takahashi)
Clin. Exp. Obstet. Gynecol. 2021, 48(1), 203–205;
Submitted: 13 June 2020 | Revised: 30 July 2020 | Accepted: 4 August 2020 | Published: 15 February 2021
Copyright: © 2021 The Authors. Published by IMR Press.
This is an open access article under the CC BY 4.0 license (

Introduction: Sepsis or septic shock, a life-threatening condition, is rarely reported as the initial manifestation of uterine malignancy. Case report: A 43-year-old woman consulted our hospital for pyrexia, anorexia, dyspnea, and a markedly distended abdomen. Computed tomography images showed a large abdominal tumor occupying almost the entire abdominal cavity with an air-fluid level and multiple masses in both lungs. Pelvic examination revealed necrotic tissues with blood, prolapsing from the uterus, and having a putrid odor. Her vital signs indicated a systemic inflammatory response syndrome. Antibiotic, anti-shock, and anti-disseminated intravascular coagulation therapies were administrated, but the patient died of multiple organ failure at 22 hours after admission. Autopsy and histopathological examination revealed that the giant abdominal mass was a uterine leiomyosarcoma, in which the myometrium was extensively necrotic with a putrid odor. The patient’s blood culture was positive for Escherichia coli, and sepsis and septic shock due to intrauterine infection of the uterine leiomyosarcoma was considered as the cause of death. Conclusions: Physicians should be aware that uterine malignancy could present as sepsis in women with an abdominal mass.

Septic shock
Systemic inflammatory response syndrome
Fig. 1.
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