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A 60 year old female with no significant past medical history presented to the Emergency department for worsening abdominal distension of 3 years duration Review of systems positive only for a weight loss of about 10 lbs in last 7 months, and negative for all others including any GI or GU symptoms. CT abdomen and pelvis with contrast demonstrated a very large mass measuring 27 × 15 × 25 cm3 , possibly arising from the uterus or ovaries. Also, seen were enlarged left renal and pelvic varices due to compression of the left renal vein and IVC by the mass. Pathology revealed leiomyosarcoma with intrauterine satellite nodules, confined to the uterus; otherwise benign parametrium with benign ovaries, fallopian tubes and cervix.
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