Unexpected Malignancy Rate of 1630 Hysterectomies Performed for Benign Indications: A 10-year Retrospective Analysis
Berrin Göktuğ KADIOĞLU1,Ayşe Nur AKSOY1,Sevilay AKALP ÖZMEN2,Paşa ULUĞ3,Özkan AYDIN4
1Department of Obstetrics and Gynecology, University of Health Sciences, Erzurum Regional Training and Research Hospital, Erzurum-Turkey
2Department of Pathology, Ataturk University Faculty of Medicine, Erzurum-Turkey
3Department of Obstetrics and Gynecology, Binali Yıldırım University Faculty of Medicine, Erzincan-Turkey
4Department of Pathology, University of Health Sciences, Erzurum Regional Training and Research Hospital, Erzurum-Turkey
DOI : 10.5505/tjo.2020.2561 OBJECTIVE
Hysterectomy is one of the most common operations in gynecology. This study aimed to investigate the incidence of occult gynecologic malignancies in women undergoing hysterectomy for benign indications.

In this retrospective study, the medical records of patients who underwent hysterectomy for benign indications between 2009-2019 were evaluated using the hospital"s electronic system.

During the study period, 1630 cases underwent hysterectomy for benign indications. The mean age of the patients was 48.4±6.9 years. The most common indications for hysterectomy were leiomyoma (n=788, 48.3%) and abnormal uterine bleeding (n=539, 33.1%). In the final histopathological evaluation results, malignancy was identified in 12 cases (0.73%), and the mean age of these cases was 50.41±12 years. These malignancies included four leiomyosarcomas (33.33%), one endometrial sarcoma (8.33%), two endometrial adenocarcinomas (16.66%), four ovarian carcinomas (33.33%), and one ovarian fibrosarcoma (8.33%). Preoperative endometrial sampling was performed in 1160 cases (71.16%). All of the occult malignant cases had preoperative endometrial sampling and no malignancy was observed in the endometrial pathology results.

Unexpected malignancy rate in women who underwent hysterectomies for benign indications was 0.73%, and 58.3% of them were related to the uterus, and 41.6% were related to ovarian tissues. Occult uterine and ovarian malignancies may be observed in hysterectomies performed for benign indications. Detailed preoperative evaluation is essential to avoid the increased risk of mortality and morbidity caused by late diagnosis of malignancy. Keywords : Benign; hysterectomy; indication; malignancy; pathology