Intraperitoneal spread in uterine sarcoma following unprotected laparoscopic transvaginal uterine morcellation: a case report and literature review

TL;DR

A case report shows how a surgical technique called unprotected morcellation may spread uterine sarcoma, leading to a worse outcome for the patient.

Contribution

The paper highlights the potential risk of using unprotected laparoscopic morcellation in cases where uterine sarcoma is not initially diagnosed.

Findings

A patient developed widespread sarcoma after undergoing unprotected morcellation during a hysterectomy.

The authors suggest that this surgical method could increase the risk of sarcoma dissemination.

A literature review is conducted to better understand the risks of this procedure.

Abstract

Clinically and through auxiliary examinations, distinguishing uterine leiomyoma from early-stage uterine sarcoma presents significant challenges. A 48-year-old patient underwent a laparoscopic hysterectomy for uterine leiomyoma, during which a large uterus was excised through the vagina and extracted. Four months post-operation, the patient developed abdominal distension, indicative of extensive pelvic-abdominal dissemination of uterine sarcoma. We hypothesize that unprotected fibroid fragmentation increases the risk of uterine sarcoma spread, thereby worsening the prognosis. Our literature review aims to thoroughly understand the risks associated with unprotected transvaginal laparoscopic tumor division.

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