An unusual presentation of endometrial cancer-diagnostic challenges and management.

This case report elucidates the atypical presentation of endometrial cancer in a postmenopausal woman, initially manifested by bladder symptoms only without postmenopausal bleeding. Imaging revealed a large cystic uterine mass suggestive of pyometra. Despite diagnostic hurdles, a total abdominal hysterectomy and bilateral oophorectomy were carried out to achieve a definitive diagnosis, which identified an endometrial adenocarcinoma, FIGO stage II on postoperative pathology. This case highlights the complexities in diagnosing and managing uterine masses, emphasising the value of thorough evaluation in cases of diagnostic uncertainty. Written informed consent was obtained from the patient for publication of this case report.