Shveiky D, Revel A, Rojansky N, Benshushan A, Shushan A. Diagnosis of malignant mesenchymal uterine tumors by hysteroscopic excisional biopsy.
J Minim Invasive Gynecol 2005;
12:29-33. [PMID:
15904594 DOI:
10.1016/j.jmig.2004.12.017]
[Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2004] [Accepted: 08/10/2004] [Indexed: 01/12/2023]
Abstract
STUDY OBJECTIVE
To emphasize the need for histologic evaluation of intrauterine lesions. Six cases of unexpected mesenchymal uterine tumors were diagnosed following pathologic review of specimens obtained during hysteroscopy to evaluate intrauterine lesions.
DESIGN
Retrospective chart review (Canadian Task Force classification II-3).
SETTING
Large tertiary care medical center.
PATIENTS
Four postmenopausal and two perimenopausal women with uterine mesenchymal tumors.
INTERVENTION
Hysteroscopy and staging laparotomy.
MEASUREMENTS AND MAIN RESULTS
Mean age of the patients was 57.5 +/- 19.5 years (mean +/- 2SD). Four women (67%) were postmenopausal. Three patients had abnormal uterine bleeding, one had a cervical mass, and the other two were asymptomatic and referred for evaluation of thick endometrium detected by routine ultrasound, which had been preformed as part of their annual check-up. In all cases, the initial hysteroscopic diagnosis was endometrial polyp or submucous myoma. Following the pathologic review, all six women underwent complete staging laparotomy. In two women, there was no residual disease in the surgical specimen. None of the patients had extrauterine spread of the disease. At mean follow-up of 21.5 +/- 9.7 months (mean +/- 2SD), all women were asymptomatic.
CONCLUSIONS
Intrauterine lesions erroneously considered to be benign endometrial polyps or myomas can turn out to be malignant mesenchymal uterine tumors. Hysteroscopic evaluation and biopsy might offer early diagnosis and treatment to these patients.
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