Submucous uterine adenosarcoma—minimally invasive treatment

Abstract

BackgroundUterine adenosarcomas are rare malignant gynaecological tumours. Due to its submucous localization, they can be easily confound with benign tumours like endometrial polyps or submucous myomas. However, the treatment of uterine adenosarcomas requires an oncologic surgical approach.Case presentationIn the following case report, we present the minimally invasive treatment of a uterine adenosarcoma by hysteroscopy and laparoscopy in a 37-year-old patient and discuss the special role of hysteroscopy in such cases.ConclusionsIn case of unknown or suspect intrauterine tumours, a diagnostic and operative hysteroscopy with biopsy could be realized prior to laparoscopic hysterectomy especially when the use of a laparoscopic electric morcellation is planned. Thus, a correct oncologic approach can be guaranteed if an adenosarcoma is diagnosed.Trial registration ISRCTN

Laparoscopic Supracervical Hysterectomy with In-Bag Morcellation in Very Large Uterus

“…A presurgical PAP smear and transvaginal ultrasound should be standard procedures and diagnostic hysteroscopy or abrasion prior to LASH might help to diagnose endometrial malignant or premalignant submucous lesions. However, rare intrauterine malignant mesenchymal tumors could be misdiagnosed as benign lesions in hysteroscopy [ 21 ]. Regarding this presurgical procedures the overall risk rate of 0.25% of unexpected malignancy in 1584 cases stays within the reported range [ 22 ].…”