Introduction. Inversion of the uterus associated with a uterine sarcoma is extremely rare with only 17 cases reported since 1887, so that its clinical presentation and appearance at laparotomy may be confusing. Case. A 26-year-old woman presented with a vaginal mass and bleeding. At laparotomy, her uterus appeared depressed or concave. The final diagnosis of uterine sarcoma and inversion was unique in her age group. Conclusions. Uterine sarcoma with inversion can occur in the premenopausal age group. It presents as a vaginal mass with bleeding. As a clue to the diagnosis, the uterus per se may not be palpable or it may appear concave on physical exam or at laparotomy.
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