Prevalence of Occult Malignancy in Patients Undergoing Hysterectomy for Benign Indications: 5-year Experience in a Tertiary Center

Abstract

Hysterectomy is the most common gynecologic surgical procedure after cesarean section worldwide. The most common indication for hysterectomy is myoma uteri, but occult malignancies may be found in the final pathology results. In this article, we aimed to analyse the pathology results of patients who underwent hysterectomy with benign indication, to review the patients with occult malignancy in hysterectomy specimens and to discuss the issues to be considered in preoperative evaluation in the light of the literature. Data of 593 patients who underwent hysterectomy between 2017 - 2021 at Gaziosmanpaşa University, Department of Obstetrics and Gynecology were collected. Preoperative malignancy and postpartum hysterectomy were exclusion criteria. Indications for hysterectomy and the prevalence of occult malignancy were examined. Uterine myoma was the most common(40%) hysterectomy indication. Occult malignancy was detected in 7(1.2%) of 593 patients. Of the 7 patients with occult malignancy, 3 had sarcoma, 1 had cervical, 2 had ovarian and 1 had tubal cancer. Preoperative endometrial biopsies of patients who underwent hysterectomy due to leiomyoma and abnormal uterine bleeding were normal. Endometrial cancer was not encountered. Although there are no preoperative screening guidelines for uterine sarcoma and ovarian cancer, our study emphasized the need for careful preoperative evaluation especially for elderly patients even with benign indications. Developing sensitive methods for preoperative screening and diagnosis to reduce the incidence of occult cancer is required.

Keywords

• Hysterectomy
• menometrorrhagia
• myoma uteri
• occult malignancy

Supporting Institution

This article has not been supported by any organisation.

Project Number

22-KAEK-123

Ethical Statement

Approving Committee: Tokat Gaziosmanpaşa University Faculty of Medicine Clinic Research Ethics Committee

Thanks

We would like to thank Assoc. Prof. Dr. Selim Gülücü for his support during the writing phase.

Benign Endikasyonlarla Histerektomi Uygulanan Hastalarda Okült Malignensi Prevalansı: 3. Basamak Bir Hastanede 5 Yıllık Deneyim

Abstract

Histerektomi, tüm dünyada sezaryen sonrası en sık uygulanan jinekolojik cerrahi prosedürdür. Histerektomi için en yaygın endikasyon myoma uteri'dir ancak nihai patoloji sonuçlarında okült maligniteler bulunabilir. Bu makalede, benign endikasyonla histerektomi yapılan hastaların patoloji sonuçlarını analiz etmeyi, histerektomi spesimenlerinde okült malignite saptanan hastaları gözden geçirmeyi ve preoperatif değerlendirmede dikkat edilmesi gereken konuları literatür ışığında tartışmayı amaçladık. Gaziosmanpaşa Üniversitesi Kadın Hastalıkları ve Doğum Anabilim Dalı'nda 2017 - 2021 yılları arasında histerektomi yapılan 593 hastanın verileri toplandı. Preoperatif malignite ve postpartum histerektomi dışlama kriterleriydi. Histerektomi endikasyonları ve okült malignite prevalansları incelendi. Uterin myom en sık(%40) histerektomi endikasyonuydu. Okült malignite 593 hastanın 7'sinde(%1,2) tespit edildi. Okült malignitesi olan 7 hastanın 3'ünde sarkom, 1'inde servikal, 2'sinde over ve 1'inde tubal kanser vardı. Leiomyom ve anormal uterin kanama nedeniyle histerektomi yapılan hastaların preoperatif endometriyal biyopsileri normaldi. Hiçbir hastada endometriyal kansere rastlanmadı. Uterin sarkom ve over kanseri için preoperatif tarama kılavuzları olmamasına rağmen, çalışmamız özellikle yaşlı hastalarda benign endikasyonlarda dahil olmak üzere dikkatli preoperatif değerlendirme yapılması gerektiğini vurguladı.

Keywords

• Histerektomi
• menometroraji
• myoma uteri
• okült malignite

Supporting Institution

Bu makale herhangi bir kurum tarafından desteklenmemiştir.

Project Number

22-KAEK-123

Ethical Statement

Onaylayan Kurul: Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu

Thanks

Doç. Dr. Selim Gülücü’ye yazım aşamasında verdiği destek için teşekkür ederiz.

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