title: Clinical characteristics and management experience of unexpected uterine sarcoma after myomectomy.
abstract: OBJECTIVE
  To identify the prevalence of unexpected uterine sarcoma after myomectomy for presumed leiomyoma and compare clinical outcomes after primary myomectomy with and without power morcellation.
  
  
  METHODS
  In a retrospective study, a review was undertaken of the medical records of patients who had unexpected uterine sarcoma after myomectomy with and without power morcellation at Peking Union Medical College Hospital, Beijing, China, between January 2009 and December 2013.
  
  
  RESULTS
  Among 4248 patients who underwent myomectomy for presumed leiomyoma, 9 (0.2%) had unexpected uterine sarcoma (1 [<0.1%] had leiomyosarcoma; 8 [0.2%] endometrial stromal sarcoma). The malignancy was identified in 5 (0.2%) of 3068 women who were treated by laparoscopy with power morcellation and 4 (0.3%) of 1180 who underwent laparotomy (P=0.274). All nine patients were alive after a mean follow-up of 31.2 months in the laparoscopy group and 40.5 months in the laparotomy group.
  
  
  CONCLUSIONS
  The overall incidence of unexpected uterine sarcoma after myomectomy was low. Incidental power morcellation of unexpected uterine sarcoma seemed to cause no increase in sarcoma dissemination.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Jiaren
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Junji
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Dai
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Jinghe
authors.initials: J
authors.lastname: Lang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. Electronic address: lengjenny@vip.sina.com.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Leng
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D007889:Leiomyoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018203:Sarcoma, Endometrial Stromal / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D055815:Young Adult
keywords: Laparoscopy; Laparotomy; Myomectomy; Power morcellation; Unexpected uterine sarcoma