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Sarcoma post-embolization for presumed uterine fibroids
Karen Buzaglo1, Ilan Bruchim, Susie K Lau
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McGill University, SMBD Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, Quebec, Canada H3T 1E2.
Background:
Uterine artery embolization has increasingly been used in the last decade as a conservative treatment approach for uterine fibroids. Rarely sarcomas have been diagnosed shortly after uterine artery embolization. It remains unclear whether a change in diagnostic work-up is required prior to uterine artery embolization in order to avoid missing sarcomas and delaying definitive treatment.
Case:
A 45 year old underwent uterine artery embolization for symptomatic uterine fibroids. Six months later, following progressive symptoms, she underwent surgery which revealed an endometrial stromal sarcoma. This manuscript raises the issue and reviews the existing literature concerning the need of tissue diagnosis prior to uterine artery embolization.
Conclusion:
Assessing the risk of malignancy by taking into account the clinical symptoms, physical exam, and imaging findings is essential prior to uterine artery embolization.