severe hemoperitoneum: spontaneous rupture of uterine leiomyosarcoma: a rare case

Uterine sarcomas, unlike the more prevalent leiomyomas, are not common. leiomyosarcoma tends to exhibit aggressive behavior and is associated with a worse prognosis. leiomyomas are notably linked to uterine rupture with hemoperitoneum. here, we present a rare case of spontaneous rupture of uterine leiomyosarcoma. a 44-year-old woman with multiple childbirths reported abdominal pain. a clinical examination indicated a large abdominal mass. after active resuscitation, computed tomography (ct) revealed an accumulation of intraperitoneal fluid and a heterogeneous mass in the uterus. the patient underwent emergency laparotomy and total hysterectomy due to a ruptured leiomyoma. the final pathology confirmed the diagnosis of leiomyosarcoma. bleeding was a result of infarction and ulceration or ruptured superficial veins caused by elevated intra-abdominal pressure. spontaneous hemorrhage from a uterine leiomyosarcoma leading to hemoperitoneum is rare. this condition should be considered in the differential diagnosis of gynecological emergencies.