Incidence, Clinical Characteristics and Outcome of Unexpected Uterine Sarcoma after Hysterectomy for Uterine Mass: A Retrospective Study of 774 Cases

Abstract

Background: Women often require a hysterectomy via laparotomy or laparoscopy. Morcellation is often necessary to perform a laparoscopic surgery. The objective of this study is to determine the incidence of unexpected uterine sarcomas (UUSs) after hysterectomy and to reduce the occurrence and avoid the morcellation of UUSs by analyzing their characteristics. Methods: Women who had a hysterectomy for various reasons in Chandulal Chandrakar Memorial Medical College, Durg, India between January 2014 and September 2016 were selected for the study, and their clinical characteristics were analyzed. Results: During the period, 5 UUSs were found in 774 cases, and the overall incidence was 0.65%. Most of the UUSs were stage I (80%), which occurred more commonly (80%) in women aged 40–49. Abnormal uterine bleeding (60%) was the main clinical manifestation. The margins of most UUSs (80%) were regular, which may cause UUSs to be misdiagnosed as uterine fibroids. Conclusion: The incidence of UUSs after hysterectomy for uterine fibroids was low, and their clinical characteristics are atypical. It is necessary and very critical to make a complete and cautious preoperative evaluation to reduce the occurrence and avoid the morcellation of UUSs.