Uterine Sarcomas in Patients Undergoing Surgery for Presumed Leiomyomas: 10 Years' Experience

Abstract

Study objective: To find the incidence of sarcomas in patients undergoing surgery for presumed leiomyomas.

Design: Retrospective study (Canadian Task Force classification II-3).

Setting: Paul's Hospital, Centre for Advanced Laparoscopy and Infertility, Kochi, India.

Patients: All women who underwent total laparoscopic hysterectomy (TLH), laparoscopic myomectomy (LM), and hysteroscopic myomectomy (HM) at Paul's Hospital for presumed leiomyomas from January 1, 2004 to December 31, 2014 that were then diagnosed as sarcomas on histopathologic examination.

Interventions: TLH, LM, and HM.

Measurements and main results: A total of 2678 patients underwent TLH, LM, and HM at Paul's Hospital for presumed leiomyomas from January 1, 2004 to December 31, 2014. Five patients were diagnosed as leiomyosarcoma and 3 patients as endometrial stromal sarcoma on histopathologic examination. Women's ages ranged from 12 to 53 years. Histopathologic diagnosis of leiomyosarcoma was made in 3 patients from the TLH group and 2 patients from the myomectomy group. Two patients from the TLH group and 1 patient from the myomectomy group were diagnosed as endometrial stromal sarcoma on histopathologic examination. The incidence of uterine sarcomas (leiomyosarcoma and endometrial stromal sarcoma) in patients undergoing surgery for presumed leiomyomas was found to be .29% (1 in 335 patients) in our study.

Conclusion: Over a period of 10 years (2004-2014), the incidence of uterine sarcomas in patients undergoing surgery for presumed leiomyomas was found to be .29% in our study.

Keywords: Endometrial stromal sarcoma; Hysteroscopic myomectomy; Laparoscopic myomectomy; Leiomyosarcoma; Sarcoma; Total laparoscopic hysterectomy.