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Published on: January 17, 2019
Hysteroscopic endomyometrial resection of three uterine sarcomas
G A Vilos1, P G Harding, A K Sugimoto
1Department of Obstetrics and Gynecology, St. Joseph's Health Care Centre, University of Western Ontario, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada.
Study Objective:
To describe our experience with three uterine sarcomas associated with hysteroscopic endometrial ablation.
Design:
Cohort study (Canadian Task Force classification II-2).
Setting:
University-affiliated teaching hospitals.
Patients:
Three of 2402 women undergoing hysteroscopic endometrial ablation who had uterine sarcomas.
Intervention:
Hysteroscopic endomyometrial resection.
Measurements And Main Results:
One low-grade endometrial stromal sarcoma and two carcinosarcomas were resected. After hysterectomy in two patients, no residual cancer was identified in one of them. The third patient was an 82-year-old woman with moderate menorrhagia who refused hysterectomy. After endomyometrial resection she remained amenorrheic for the last 14 months of her life.
Conclusion:
From our experience the incidence of uterine sarcomas is approximately 1/800 women undergoing hysteroscopic ablation for abnormal uterine bleeding. Complete endomyometrial resection is feasible and may be offered as diagnostic and palliative therapy in women at high risk for hysterectomy.
