Secondary Postpartum Haemorrhage: A Rare Presentation of Secondary Uterine Mantle Cell Lymphoma

Postpartum haemorrhage (PPH) is rarely the initial presentation of a disseminated non-Hodgkin lymphoma (NHL). Herein, we describe the very first case of a uterine mantle cell lymphoma (MCL) presenting with PPH. A 30-year-old P1L1 female patient presented with secondary PPH following an emergency caesarean section. Ultrasonogram revealed a hypo-echoic mass in the uterine cavity, histopathological examination of which revealed MCL. Metastatic evaluation of the patient showed a widespread disease with skeletal and lymph node involvement. She was staged Ann Arbor IV NHL with International Prognostic Index (IPI) of 2/5. Despite chemoradiation, she succumbed to leptomeningeal spread and expired 5 months from diagnosis. The involvement of female genital organs by malignant lymphomas is a rare but possible scenario with perilous outcomes. The unusual clinical presentations necessitate a high degree of suspicion with prompt pathological confirmation and individualised therapy.