New Challenges in Detecting, Grading, and Staging Endometrial Cancer After Uterine Morcellation

Rivard, Colleen; Salhadar, Alia; Kenton, Kimberly

doi:10.1016/j.jmig.2011.12.019

Cited by 51 publications

(31 citation statements)

References 13 publications

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“…One dilemma surrounding morcellation is the difficulty in proper pathologic evaluation after the procedure. 59 Assessment of the endometrial mucosa in morcellated uterine tissue is a majorchallenge,andfocalmalignantlesions may be inaccurately graded or missed entirely. 59 Disruption of the architecture also precludes the analysis of myometrial invasion by tumor, resulting in the nearly impossible task of pathologic staging.…”

Section: Risk Of Dissemination and Upstaging With Morcellationmentioning

confidence: 99%

“…59 Assessment of the endometrial mucosa in morcellated uterine tissue is a majorchallenge,andfocalmalignantlesions may be inaccurately graded or missed entirely. 59 Disruption of the architecture also precludes the analysis of myometrial invasion by tumor, resulting in the nearly impossible task of pathologic staging. 19,59 Giventhedifficultyinpathologicevaluation and likelihood of tumor dissemination, surgical restaging is recommended after inadvertent morcellation of a malignancy to ensure complete resection of residual peritoneal disease.…”

Section: Risk Of Dissemination and Upstaging With Morcellationmentioning

confidence: 99%

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Risk of Occult Uterine Sarcoma in Presumed Uterine Fibroids

Cui

Wright

2016

Clinical Obstetrics &Amp; Gynecology

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Symptomatic fibroids are a common indication for hysterectomy or myomectomy. Although rare, unexpected gynecologic malignancies in presumed fibroids have been documented. In cases where tissue retrieval is performed through morcellation, there is increasing concern that intra-abdominal dispersion of occult uterine malignancies may lead to peritoneal dissemination and worse outcomes. We examined the available literature to determine the prevalence of all uterine cancers in women undergoing hysterectomy or myomectomy for benign uterine disease, with attention to the risk of morcellating occult uterine sarcomas. We also reviewed the available tools for preoperative discrimination between benign and malignant uterine disease.

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Section: Risk Of Dissemination and Upstaging With Morcellationmentioning

confidence: 99%

Section: Risk Of Dissemination and Upstaging With Morcellationmentioning

confidence: 99%

Risk of Occult Uterine Sarcoma in Presumed Uterine Fibroids

Cui

Wright

2016

Clinical Obstetrics &Amp; Gynecology

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“…We hypothesized that those numbers resulted from the diagnostical dilemma caused by morcellated tumor tissue. Missing pathological determination of depth of myometrial invasion and the inability to evaluate the borders of the lesion and the necrosis are reported in literature [22][23][24]. If the better outcomes were real then it could be possible that with respect to embryologically determined compartment association and topical information of tumor cells and hosts immune system at least part of the ULMS are not able to implant on the peritoneal surface.…”

Section: Discussionmentioning

confidence: 99%

Effects of morcellation on long-term outcomes in patients with uterine leiomyosarcoma

Nemec

Inwald

Buchholz

et al. 2016

Arch Gynecol Obstet

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“…Gross examination of morcellated hysterectomy tissue can be challenging because tissue is fragmented and anatomic landmarks for specimen orientation are lost [15,16]. It is also difficult to grossly assess the cut surface of fibroids due to fragmentation.…”

Section: Discussionmentioning

confidence: 99%

Case report: MR imaging features of disseminated uterine leiomyosarcoma presenting after hysterectomy with morcellation

et al. 2015

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A 53-year-old woman underwent elective hysterectomy for symptomatic anemia secondary to abnormal uterine bleeding. She presented 15 months later with complaints of abdominal fullness. Abdominopelvic magnetic resonance imaging demonstrated multiple confluent enhancing solid masses centered in the pelvis and extending cranially to the level of the umbilicus. Additional separate nodules also were visible along the peritoneum. Biopsy demonstrated leiomyosarcoma. Additional clinical information was obtained, which revealed that the patient's prior hysterectomy was performed with morcellation. In November 2014, the United States Food and Drug Administration issued a warning discouraging the use of morcellation during hysterectomy and myomectomy because of the risk of seeding unsuspected malignancy. Radiologists should be aware of this potential complication of morcellation and its imaging appearance so that the correct diagnosis can be suggested in the imaging report.

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New Challenges in Detecting, Grading, and Staging Endometrial Cancer After Uterine Morcellation

Cited by 51 publications

References 13 publications

Risk of Occult Uterine Sarcoma in Presumed Uterine Fibroids

Risk of Occult Uterine Sarcoma in Presumed Uterine Fibroids

Effects of morcellation on long-term outcomes in patients with uterine leiomyosarcoma

Case report: MR imaging features of disseminated uterine leiomyosarcoma presenting after hysterectomy with morcellation

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