Risk of Occult Uterine Sarcoma in Presumed Uterine Fibroids

Cui, Rosa R.; Wright, Jason D.

doi:10.1097/grf.0000000000000163

Cited by 25 publications

(22 citation statements)

References 65 publications

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“…The incidence of post-operatively diagnosed sarcomas (LMS and endometrial stromal sarcoma) has been estimated to be between 1:350 to 1.4:500 in patients undergoing hysterectomies or myomectomies (Park et al, 2011, Lissoni et al, 1998, Food and Drug Administration, 2014, Kamikabeya et al, 2010). The largest single institution series showed the incidence of sarcomas to be 20:4785 patients (Cui and Wright, 2016). …”

Section: Discussionmentioning

confidence: 99%

Incidental leiomyosarcoma found at the time of cesarean hysterectomy for morbidly adherent placenta

Hand

Gimovsky

Chan

et al. 2017

Gynecologic Oncology Reports

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BackgroundIncidental leiomyosarcoma (LMS) is a rare diagnosis in pregnancy or in the puerperium. To our knowledge, this is the first case reported in the literature of incidental LMS after cesarean hysterectomy for morbidly adherent placenta.CaseWe present a case of a cesarean hysterectomy performed for a suspected morbidly adherent placenta in a patient with three prior cesarean deliveries, an anterior placenta previa and a fundal fibroid. Subsequent pathology identified a LMS on final specimen. The patient declined bilateral oophorectomy and removal of her remaining cervix. No chemotherapy or radiation was given for her presumed stage IB disease.ConclusionAn incidental finding of a LMS is infrequent; the risk of recurrence is > 50% even if the sarcoma is removed in its entirety.

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Section: Discussionmentioning

confidence: 99%

Incidental leiomyosarcoma found at the time of cesarean hysterectomy for morbidly adherent placenta

Hand

Gimovsky

Chan

et al. 2017

Gynecologic Oncology Reports

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show abstract

“…In laparoscopy, the possibility of facing a uterine sarcoma (leiomyosarcoma followed by endometrial stromal sarcoma and carcinosarcoma) misdiagnosed as myoma exists, with a prevalence that ranges from 0.00% to 0.49% [ 80 ], although the risk has been probably overestimated [ 21 ]. To eliminate the risk of inadvertent tissue spread during surgery, “in bag” myoma excision and morcellation have been proposed to avoid ethical and medicolegal issues in case of unexpected malignancy [ 81 – 83 ].…”

Section: Uterine Myomasmentioning

confidence: 99%

Myomas and Adenomyosis: Impact on Reproductive Outcome

Vlahos

Theodoridis

Partsinevelos

2017

BioMed Research International

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Among uterine structural abnormalities, myomas and adenomyosis represent two distinct, though frequently coexistent entities, with a remarkable prevalence in women of reproductive age. Various mechanisms have been proposed to explain the impact of each of them on reproductive outcome. In respect to myomas, current evidence implies that submucosal ones have an adverse effect on conception and early pregnancy. A similar effect yet is not quite clear and has been suggested for intramural myomas. Still, it seems reasonable that intramural myomas greater than 4 cm in diameter may negatively impair reproductive outcome. On the contrary, subserosal myomas do not seem to have a significant impact, if any, on reproduction. The presence of submucosal and/or large intramural myomas has also been linked to adverse pregnancy outcomes. In particular increased risk for miscarriage, fetal malpresentation, placenta previa, preterm birth, placenta abruption, postpartum hemorrhage, and cesarean section has been reported. With regard to adenomyosis, besides the tentative coexistence of adenomyosis and infertility, to date a causal relationship among these conditions has not been fully confirmed. Preterm birth and preterm premature rupture of membranes, uterine rupture, postpartum hemorrhage due to uterine atony, and ectopic pregnancy have all been reported in association with adenomyosis. Further research on the impact of adenomyosis on reproductive outcome is welcome.

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“…Among them, 34 cases (28%) incurred uterus morcellation, which may increase the risk of postoperative metastasis within three months. Recently, other studies also showed that laparoscopic surgery may lead to malignant planting in operating hole, abdominal and pelvic sarcoma 11 49 51 52 53 .…”

Section: Uterus Morcellation and Metastasis Of Uterine Sarcomamentioning

confidence: 99%

Laparoscopic surgery on broken points for uterine sarcoma in the early stage decrease prognosis

Liu

Zhu

Zhang

et al. 2016

Sci Rep

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Uterine sarcoma, a rare solid tumor in uterus, is difficult to identify in the early stage from some benign uterine tumors, such as uterine fibroids. Hence, uterine sarcoma may be treated in the same way as uterine fibroids; and this may not be found until pathological diagnosis. Consequently, this can lead to tumor’s abdominal spread, planting and local invasive growth, resulting in an early uterine sarcoma, an increased relapse rate after surgery and a decreased survival. Therefore, it’s important to avoid these unintended and iatrogenic complications through an accurate diagnosis and an appropriate surgical approach. The surgical staging and a complete resection of the tumor are both important for patients’ prognosis. In this review, we will discuss the laparoscopic surgery for uterine sarcoma in the early stage and patients’ prognosis.

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Risk of Occult Uterine Sarcoma in Presumed Uterine Fibroids

Cited by 25 publications

References 65 publications

Incidental leiomyosarcoma found at the time of cesarean hysterectomy for morbidly adherent placenta

Incidental leiomyosarcoma found at the time of cesarean hysterectomy for morbidly adherent placenta

Myomas and Adenomyosis: Impact on Reproductive Outcome

Laparoscopic surgery on broken points for uterine sarcoma in the early stage decrease prognosis

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