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.
METHODS
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.
RESULTS
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.
CONCLUSION
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.