title: Intrapelvic dissemination of early low-grade endometrioid stromal sarcoma due to electronic morcellation.
abstract: Endometrioid stromal sarcoma is a rare malignancy that originates from mesenchymal cells. It is classified into low-grade endometrioid stromal sarcoma (LGESS) and high-grade endometrioid stromal sarcoma. Ultrasonographic findings of LGESS resemble those of submucosal myomas, leading to the possible preoperative misdiagnosis of LGESS as uterine leiomyoma. Electronic morcellation during laparoscopic surgery in women with LGESS can result in iatrogenic intraabdominal dissemination and a poorer prognosis. Here, we report a patient with LGESS who underwent a supracervical hysterectomy and electronic morcellation for a presumed myoma in another hospital. Disseminated metastatic lesions of LGESS in the posterior cul-de-sac and rectal serosal surface were absent on primary surgery, but found during reexploration. In conclusion, when LGESS is found incidentally following previous morcellation during laparoscopic surgery for presumed benign uterine disease, we highly recommend surgical reexploration, even when there is no evidence of a metastatic lesion in imaging studies.
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Kyoung-Ja
authors.initials: KJ
authors.lastname: Choo
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Suk Bong
authors.initials: SB
authors.lastname: Koh
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Youn Seok
authors.initials: YS
authors.lastname: Choi
keywords: Endometrial stromal sarcoma; Leiomyoma; Morcellation; Uterus