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Sun J, Jiao X, Wu Z, Yao T, Tuo S, Wang Y, Chen R, He J, Qian J, Xu S, Liu Q. Intraperitoneal spread in uterine sarcoma following unprotected laparoscopic transvaginal uterine morcellation: a case report and literature review. Front Oncol 2024; 14:1434720. [PMID: 39188684 PMCID: PMC11345641 DOI: 10.3389/fonc.2024.1434720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 07/24/2024] [Indexed: 08/28/2024] Open
Abstract
Clinically and through auxiliary examinations, distinguishing uterine leiomyoma from early-stage uterine sarcoma presents significant challenges. A 48-year-old patient underwent a laparoscopic hysterectomy for uterine leiomyoma, during which a large uterus was excised through the vagina and extracted. Four months post-operation, the patient developed abdominal distension, indicative of extensive pelvic-abdominal dissemination of uterine sarcoma. We hypothesize that unprotected fibroid fragmentation increases the risk of uterine sarcoma spread, thereby worsening the prognosis. Our literature review aims to thoroughly understand the risks associated with unprotected transvaginal laparoscopic tumor division.
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Affiliation(s)
- Jianhao Sun
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Xinjuan Jiao
- Qingyang Second People’s Hospital, Qingyang, Gansu, China
| | - Zhenzhen Wu
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Tingting Yao
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Shumei Tuo
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Yueyuan Wang
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Ruirong Chen
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Jing He
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Jifang Qian
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Shengfang Xu
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Qing Liu
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
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Szubert M, Kozirog E, Wilczynski J. Adenomyosis as a Risk Factor for Myometrial or Endometrial Neoplasms-Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2294. [PMID: 35206475 PMCID: PMC8872164 DOI: 10.3390/ijerph19042294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 11/16/2022]
Abstract
Adenomyosis is a common benign gynecological condition, defined as an extension of endometrial tissue into the myometrium. Some studies suggest that adenomyosis could be a favorable prediction factor associated with survival outcomes in endometrial cancer. The aim of our systematic review was to investigate the current knowledge regarding adenomyosis and a possible molecular mechanism of carcinogenesis in adenomyotic lesions. In addition, the long-term prognosis for patients with endometrial cancer and coexisting adenomyosis (and endometriosis) was a key point of the research. The current literature was reviewed by searching PubMed, using the following phrases: "adenomyosis and endometrial cancer" and "malignant transformation of adenomyosis". According to the literature, genetic mutations, epigenetic changes, and inactivation of specific tumor suppressor genes in adenomyosis are still poorly understood. Data regarding the influence of adenomyosis on survival outcomes in endometrial cancer seem to be contradictory and require further clinical and molecular investigation.
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Affiliation(s)
- Maria Szubert
- Clinic of Surgical and Oncologic Gynecology, 1st Department of Gynecology and Obstetrics, Medical University of Lodz, M. Pirogow’s Teaching Hospital, Wilenska 37 St., 94-029 Lodz, Poland; (E.K.); (J.W.)
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