Incidence of occult malignancies identified during hysterectomies performed for benign indications

Hysterectomy is a commonly performed gynaecological procedure worldwide. Although most hysterectomies are performed for benign indications, the possibility of an unexpected malignancy in the final pathology results should be considered. The aim of our study was to investigate the evaluation and management of patients who underwent hysterectomy for benign reasons but were diagnosed with a malignancy in the final pathology results.

We retrospectively examined the medical records of patients who underwent hysterectomy for benign indications between 2011 and 2017, and recorded the information obtained from these patient files.

In total, 1050 patients who underwent hysterectomy for benign indications were included in the study. Among these patients, 127 underwent hysterectomy for uterine prolapse, 230 for uterine myoma, 223 for treatment-resistant menometrorrhagia, 150 for treatment-resistant menometrorrhagia and uterine myoma, 61 for endometriosis, 108 for ovarian cysts, 45 for endometrial polyps, and 106 for treatment-resistant menometrorrhagia and ovarian cysts. In 13 of these patients, malignancy was unexpectedly identified via the final pathology results. Seven of these patients had sarcoma, three had cervical cancer, two had ovarian cancer, and one had metastasis of a haematological malignancy.

Malignancy was identified in 13 of the 1050 patients included in our study. The incidence of unexpected malignancy in these patients who underwent hysterectomies performed for benign indications was determined to be 1.23%. Seven of these 13 patients had sarcoma. Our results demonstrate the absence of reliable data for preoperative detection of sarcoma.