Spontaneous perforation of pyometra presenting as generalized peritonitis in a patient with cervical cancer.

Pyometra is a relatively common event. However, it is extremely rare for this condition to perforate spontaneously into the peritoneum, and to date only 14 cases have been reported in English literature. We recently experienced such a case in a patient with cervical cancer. The clinical features, pathologic findings, diagnosis, therapy, and outcome of these 15 cases were reviewed. Only 5 cases were associated with malignant diseases, consisting of 2 cervical cancers, 2 colon cancers, and 1 endometrial cancer. All of the patients developed generalized peritonitis, and 4 patients died of this. Correct preoperative diagnosis was difficult. Therefore, immediate and appropriate therapy is important.