Clinical Edge

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Risk of Occult Uterine Sarcoma

Women undergoing surgery for benign indications

There was a low risk of occult uterine sarcoma in women undergoing hysterectomy for benign indications, a frequency lower than the rate derived in earlier reports by the US Food and Drug Administration (FDA) in a pooled analysis. This according to a study of patients and 10,119 hysterectomies for benign gynecologic indications over a 14-year period. Researchers found:

• 9 patients were found to have uterine sarcoma (0.089%), with an overall rate of 1 in 1,124.

• The malignancies included 5 leiomyosarcomas, 2 endometrial stromal sarcomas, and 2 uterine adenosarcomas.

• Among women with occult sarcoma, hysterectomy was performed as a primary indication for abnormal bleeding (77.8%) and leiomyomas (22.2%).

• Cases included 6 total abdominal hysterectomies, 2 total vaginal hysterectomies, and 1 supracervical hysterectomy.

• 1 case required manual morcellation during abdominal hysterectomy.

Citation: Kho KA, Lin K, Hechanova M, Richardson DL. Risk of occult uterine sarcoma in women undergoing hysterectomy for benign indications. [Published online ahead of print February 4, 2016]. Obstet Gynecol. doi: 10.1097/AOG 0000000000001242.