Hysterectomy is the most common gynecologic procedure performed all over the world and various complications may appear depending on the surgical route. Delayed postoperative hemorrhage is a rare, life threatening complication. It requires timely management and recently the surgical reinterventions tend to be replaced by minimally invasive techniques. Transcatheter arterial embolization shows good results as a treatment strategy for massive vaginal bleeding post hysterectomy, when vaginal vault suturing fails to achieve hemostasis. We report a case of right uterine artery bleeding occurring 30 days after vaginal hysterectomy that was successfully treated by transcatheter arterial embolization.

In Bucharest University Emergency Hospital every day we deal with difficult cases either presented per primam in our setting or, even more difficult situations, cases that were intended to be treated in other hospitals but due to lack of infrastructure are sent towards our multidisciplinary hospital, as a final stop. Conditions that our teams have to deal in a very restricted amount of time in the Emergency Room are: submucous myoma with heavy bleeding acquired uterine arteriovenous fistulae, ovarian ruptured cyst , ovarian hyperstimulation syndrome, adnexal torsion, tuboovarian abscess, classical tubal ectopic pregnancy, Cesarean scar ectopic pregnancy, molar pregnancy, incomplete abortion, ruptured uterus post minimally invasive procedures performed before pregnancy, placental abruption, placenta praevia with heavy bleeding, and the PAS – Placenta Accreta Spectrum. All these conditions recquire a rapid differential diagnosis where ultrasonography is useful in adopting a tailored management either conservative or radical, in avoidance of haemorhagic accidents or even death and, when needed, in fertility sparing.

Metaplastic breast cancer (MBC) is a rare, aggressive form of breast cancer first described by pathologists in 2000. It is usually discovered in advanced stages and has a low survival rate. It is divided into various subtypes: lowgrade adenosquamous, fibromatosis-like metaplastic, squamous cell, spindle cell, metaplastic with mesenchymal differentiation (including chondroid, osseous, or other types), mixed metaplastic, and myoepithelial carcinomas. Surgery is the treatment of choice, followed by adjuvant chemotherapy and/or radiotherapy. We present the case of a 44-year-old woman with metaplastic breast cancer, reviewing the characteristics of this condition, the particularities of the case, and the treatment chosen in this particular situation.