Open AccessIntrapelvic dissemination of early low-grade endometrioid stromal sarcoma due to electronic morcellation
Author(s) -
Kyoung-Ja Choo,
Hyun Joo Lee,
Tae Sung Lee,
Ju Hyun Kim,
Suk Bong Koh,
Youn Seok Choi
Publication year - 2015
Publication title -
obstetrics and gynecology science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 10
eISSN - 2287-8580
pISSN - 2287-8572
DOI - 10.5468/ogs.2015.58.5.414
Subject(s) - medicine , myoma , malignancy , leiomyoma , sarcoma , stromal cell , endometrial stromal sarcoma , hysterectomy , stromal tumor , radiology , surgery , uterus , pathology
Endometrioid stromal sarcoma is a rare malignancy that originates from mesenchymal cells. It is classified into low-grade endometrioid stromal sarcoma (LGESS) and high-grade endometrioid stromal sarcoma. Ultrasonographic findings of LGESS resemble those of submucosal myomas, leading to the possible preoperative misdiagnosis of LGESS as uterine leiomyoma. Electronic morcellation during laparoscopic surgery in women with LGESS can result in iatrogenic intraabdominal dissemination and a poorer prognosis. Here, we report a patient with LGESS who underwent a supracervical hysterectomy and electronic morcellation for a presumed myoma in another hospital. Disseminated metastatic lesions of LGESS in the posterior cul-de-sac and rectal serosal surface were absent on primary surgery, but found during reexploration. In conclusion, when LGESS is found incidentally following previous morcellation during laparoscopic surgery for presumed benign uterine disease, we highly recommend surgical reexploration, even when there is no evidence of a metastatic lesion in imaging studies.