Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation

Introduction. Power morcellation is an effective and minimally invasive technique used to remove specimen tissues or the uterus in total laparoscopic hysterectomy (TLH). However, it has the risk of intraperitoneal dissemination of tissue and can cause a parasitic myoma. We report a case of leiomyosa...

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Main Authors: Tsukasa Takahashi, Tomohisa Ugajin, Noriaki Imai, Atsushi Hayasaka, Nobuo Yaegashi, Takeo Otsuki
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2019/9381230
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author Tsukasa Takahashi
Tomohisa Ugajin
Noriaki Imai
Atsushi Hayasaka
Nobuo Yaegashi
Takeo Otsuki
author_facet Tsukasa Takahashi
Tomohisa Ugajin
Noriaki Imai
Atsushi Hayasaka
Nobuo Yaegashi
Takeo Otsuki
author_sort Tsukasa Takahashi
collection DOAJ
description Introduction. Power morcellation is an effective and minimally invasive technique used to remove specimen tissues or the uterus in total laparoscopic hysterectomy (TLH). However, it has the risk of intraperitoneal dissemination of tissue and can cause a parasitic myoma. We report a case of leiomyosarcoma that occurred 4 years after TLH with power morcellation for fibroids. Case. A 52-year-old woman was referred to our hospital with a pelvic mass. She was diagnosed to have submucosal fibroids and had undergone TLH with power morcellation 4 years previously. The uterus weighed 398 g at that time. At present, a parasitic myoma was suspected, owing to the diagnosis of fibroids on the initial pathological evaluation. She underwent laparotomy, and the tumor was removed. Although the pathological evaluation confirmed the tumor to be a leiomyosarcoma, a review of the initial tissue did not show the presence of any malignancy. Since there was no metastasis, she was followed-up without additional treatment. Conclusion. Even if the initial pathologic evaluation suggests a benign mass, parasitic myoma and even sarcoma can occur after TLH with power morcellation. Considering the risk of dissemination and occult malignancy, the use of power morcellation should be avoided if there are alternative options to remove the tumor.
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institution Kabale University
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language English
publishDate 2019-01-01
publisher Wiley
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series Case Reports in Obstetrics and Gynecology
spelling doaj-art-21e8371945c549e786d486cb6bc2fecf2025-02-03T06:00:58ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922019-01-01201910.1155/2019/93812309381230Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power MorcellationTsukasa Takahashi0Tomohisa Ugajin1Noriaki Imai2Atsushi Hayasaka3Nobuo Yaegashi4Takeo Otsuki5Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Obstetrics and Gynecology, Sendai City Hospital, Sendai, Miyagi, JapanDepartment of Obstetrics and Gynecology, Sendai City Hospital, Sendai, Miyagi, JapanDepartment of Obstetrics and Gynecology, Sendai City Hospital, Sendai, Miyagi, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Obstetrics and Gynecology, Sendai City Hospital, Sendai, Miyagi, JapanIntroduction. Power morcellation is an effective and minimally invasive technique used to remove specimen tissues or the uterus in total laparoscopic hysterectomy (TLH). However, it has the risk of intraperitoneal dissemination of tissue and can cause a parasitic myoma. We report a case of leiomyosarcoma that occurred 4 years after TLH with power morcellation for fibroids. Case. A 52-year-old woman was referred to our hospital with a pelvic mass. She was diagnosed to have submucosal fibroids and had undergone TLH with power morcellation 4 years previously. The uterus weighed 398 g at that time. At present, a parasitic myoma was suspected, owing to the diagnosis of fibroids on the initial pathological evaluation. She underwent laparotomy, and the tumor was removed. Although the pathological evaluation confirmed the tumor to be a leiomyosarcoma, a review of the initial tissue did not show the presence of any malignancy. Since there was no metastasis, she was followed-up without additional treatment. Conclusion. Even if the initial pathologic evaluation suggests a benign mass, parasitic myoma and even sarcoma can occur after TLH with power morcellation. Considering the risk of dissemination and occult malignancy, the use of power morcellation should be avoided if there are alternative options to remove the tumor.http://dx.doi.org/10.1155/2019/9381230
spellingShingle Tsukasa Takahashi
Tomohisa Ugajin
Noriaki Imai
Atsushi Hayasaka
Nobuo Yaegashi
Takeo Otsuki
Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation
Case Reports in Obstetrics and Gynecology
title Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation
title_full Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation
title_fullStr Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation
title_full_unstemmed Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation
title_short Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation
title_sort leiomyosarcoma after total laparoscopic hysterectomy with power morcellation
url http://dx.doi.org/10.1155/2019/9381230
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AT tomohisaugajin leiomyosarcomaaftertotallaparoscopichysterectomywithpowermorcellation
AT noriakiimai leiomyosarcomaaftertotallaparoscopichysterectomywithpowermorcellation
AT atsushihayasaka leiomyosarcomaaftertotallaparoscopichysterectomywithpowermorcellation
AT nobuoyaegashi leiomyosarcomaaftertotallaparoscopichysterectomywithpowermorcellation
AT takeootsuki leiomyosarcomaaftertotallaparoscopichysterectomywithpowermorcellation