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. 2022 Feb;156(2):236-239.
doi: 10.1002/ijgo.13701. Epub 2021 May 5.

Risk of unexpected uterine leiomyosarcoma during laparoscopic procedures: Experience from a single tertiary institute in Italy

Alessandra Surace  1 , Maria Grazia Baù  2 , Sebastiana Privitera  3 , Giovanni Botta  3 , Saverio Danese  4 , Claudio Plazzotta  5 , Marco Mitidieri  4 , Elisa Picardo  4
Affiliations

Risk of unexpected uterine leiomyosarcoma during laparoscopic procedures: Experience from a single tertiary institute in Italy

Alessandra Surace et al. Int J Gynaecol Obstet. 2022 Feb.

Abstract

Objective: To evaluate the incidence of occult uterine sarcomas and investigate whether an accurate and well-established preoperative assessment for uterine fibroids could help identify uterine sarcomas more effectively.

Methods: A retrospective analysis of patients who underwent gynecological laparoscopic surgery for presumed uterine fibroids at Sant'Anna Hospital, a single tertiary institute in Turin, Italy, between January 2003 and December 2019.

Results: Over the 17-year period, 5826 laparoscopic surgical procedures (myomectomies or subtotal/total hysterectomies) were performed for presumed uterine fibroids. A total of 48 patients with a final diagnosis of uterine sarcoma were identified, the majority of which (n = 39; 81.3%) were recognized as suspicious uterine sarcomas during the preoperative assessment, and morcellement was avoided. The occurrence of unexpected uterine sarcomas was 0.1% (6/5826). Morcellation was conducted in one patient with uterine sarcoma.

Conclusion: Analysis of our data showed that unexpected uterine sarcomas are uncommon. Accurate preoperative evaluation can help avoid, but does not exclude, the possibility of morcellation of unknown uterine sarcomas.

Keywords: laparoscopy; leiomyosarcoma; morcellation; ultrasound; uterine fibroids; uterine sarcomas.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Ultrasound features of a leiomyosarcoma identified from the study sample. (a) Multilocular‐solid lesion with anechoic content (76 × 66 × 71 mm). (b–d) Color score 4 from the posterior uterine wall
See this image and copyright information in PMC

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