A 64-year-old female presented with intermittent post-menopausal bleed for 3 months. A pelvic ultrasound done by her gynaecologist revealed a uterine enlargement from a large uterine mass measuring 10 cm in diameter with central necrosis and increased vascularity seen on Doppler. An endometrial sampling was performed showing features suspicious of a possible spindle cell neoplasm. An MRI done revealed a heterogeneous anterior myometrial mass with irregular margins (Fig. 1). A staging CT thorax, abdomen and pelvis did not reveal any evidence of systemic metastases. After a discussion with her gynaecologist, she opted for a total hysterectomy and bilateral salphingo-oopherectomy and underwent surgical excision uneventfully. Histological examination of the resected specimen was consistent with a uterine leiomyosarcoma arising from the myometrium with clear resection margins.