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New challenges in detecting, grading, and staging endometrial cancer after uterine morcellation
Colleen Rivard1, Alia Salhadar, Kimberly Kenton
1Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL 60153, USA. crivardhunt@gmail.com
Study Objective:
To evaluate the accuracy in diagnosing endometrial disease after uterine morcellation.
Design:
Prospective case series.
Setting:
University medical center.
Patients:
Five women undergoing hysterectomy without morcellation because of benign indications and 5 women with endometrial cancer.
Interventions:
Uterine specimens were obtained from all 10 study patients. The uteri were sent for pathologic analysis, processed, and fixed according to standard protocols. A single investigator then morcellated all 10 uteri. A single pathologist blinded to specimen group reviewed each specimen.
Main Results:
The pathologist identified endometrial cancer in 4 of 5 specimens of known cancer. The fifth specimen was interpreted as benign despite the presence of grade 1, stage IA endometrial adenocarcinoma. None of the morcellated specimens could be staged.
Conclusion:
The increasing use of uterine morcellation will result in new challenges for gynecologic oncologists secondary to difficulty in detection, and accurate grading and staging of endometrial cancer.
