Uterine leiomyomas are the most common indication for hysterectomy in the United States ( 2). The disease affects the quality of life of many women.ĭuring routine gynecological practice, leiomyomas are encountered frequently and when symptomatic they are often treated by surgical procedures such as hysterectomy and myomectomy. Women with leiomyomas often present with abnormal uterine bleeding, pelvic pain, infertility, and pregnancy complications ( 1). Approximately 70% of white women and 80% of black women are affected ( 1). Uterine leiomyomas (fibroids or myomas) are benign tumors of the uterine smooth muscle and the most common pelvic tumor in women during their reproductive years. Received: 04 August 2021 Accepted: 04 July 2022 Published: 25 September 2022. Keywords: Leiomyosarcoma (LMS) leiomyoma morcellation occult leiomyosarcoma fibroid Up to date, there are no definitive diagnostic approaches.
These novel approaches might improve preoperative detection rates and augment referral to gynecologic oncologists for optimal treatment.Ĭonclusions: Even though there are some promising reports, more studies with bigger cohorts are needed to determine accurate preoperative diagnostic methods. Also, there are some novel studies on frozen sections’ diagnostic accuracy opposing the general opinion on this subject. Key Content and Findings: We summarized preoperative findings on imaging modalities and laboratory studies implicating malignancy, and innovative scoring systems combining these with up to 80% accuracy and in which patients morcellation is appropriate to use. All related articles’ abstracts were reviewed by one author, then selected articles were reviewed by one other author. Also all publications’ bibliographies were searched for relevant articles. Methods: On May 23 rd, 2021 PubMed database and the Cochrane Library were searched for original articles, reviews, meta-analyses, and case reports in English published after Jan 1 st, 1990.
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This review aims to discuss the prevalence of LMS, whether there is an effective method to predict the malignant potential of a presumed benign leiomyoma, what should be considered pre and perioperatively, and how to approach inadvertent morcellation of uterine LMS. Food and Drug Administration’s estimated prevalence of uterine LMSs is contradicted by many meta-analyses comprising more publications. In recent years there has been debate on its prevalence and whether minimally invasive surgical techniques and morcellation are suitable to use. With the increasing use of minimally invasive techniques during surgery, misdiagnosis of LMS results in possible dissemination of malignant tissue throughout the abdominal cavity, and significant treatment delays which in turn increase morbidity and mortality. Women present with similar symptoms and characteristics on imaging modalities is a challenge due to many overlapping features, in most cases the diagnosis is confirmed post-operatively for presumed benign disease. Policy of Dealing with Allegations of Research Misconductīackground and Objective: Uterine leiomyomas, the most common pelvic tumor in women during their reproductive years, and leiomyosarcomas (LMSs) are remarkably similar to each other and the preoperative distinction between the two is a challenge for gynecologists.
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