title: Morcellating uterine mesenchymal tumors: The pathologist's view.
abstract: OBJECTIVE
  The study was conducted to delineate the histological problems in diagnosing uterine mesenchymal tumors in morcellated material.
  
  
  METHODS
  All cases of morcellated uteri performed between 2008 and 2014 were reviewed. The incidence of unexpected malignancy, defined as any neoplasm with a clear-cut diagnosis of leiomyosarcoma (LMS) or endometrial stromal sarcoma (ESS), was noted. Cases with absolute discrepancy between the diagnosis of the morcellated tumor and the subsequent diagnosis were also included in the study.
  
  
  RESULTS
  Out of 631 cases, a final diagnosis of LMS or ESS was made regarding three and five tumors, respectively. Patient age ranged from 25 to 48 years. Two further cases initially diagnosed as ESS proved to be endometrial stromal nodules with smooth muscle differentiation. Two cases were diagnosed as smooth muscle tumors with uncertain malignant potential and the patients remain free of disease. One tumor was diagnosed as an endometrial stromal neoplasm and proved to be benign and finally a leiomyoma variant presented with presumed peritoneal disease.
  
  
  CONCLUSIONS
  Both endometrial stromal and smooth muscle tumors with malignant behavior can be encountered at a young age. Because of the limitations in histological evaluation, morcellated tumors may be overdiagnosed or underdiagnosed by pathologists.
authors.affiliation: Pathology Department, IASO Women's Hospital, Maroussi, Greece.|Pathology Department, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Kitty
authors.initials: K
authors.lastname: Pavlakis
authors.affiliation: Pathology Department, IASO Women's Hospital, Maroussi, Greece.
authors.forename: Irini
authors.initials: I
authors.lastname: Messini
authors.affiliation: Pathology Department, IASO Women's Hospital, Maroussi, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Yiannou
authors.affiliation: Pathology Department, IASO Women's Hospital, Maroussi, Greece.
authors.forename: Theofani
authors.initials: T
authors.lastname: Gavresea
authors.affiliation: Pathology Department, IASO Women's Hospital, Maroussi, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Chrysanthakis
authors.affiliation: IASO Women's Hospital Athens Greece and Stanford University Hospital, Stanford, California, USA.|Stanford University Hospital, Stanford, California, USA.
authors.forename: Georgios
authors.initials: G
authors.lastname: Hilaris
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Medical School National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Panoskaltsis
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D000069577:Morcellation; D018203:Sarcoma, Endometrial Stromal / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery
keywords: pathology; unsuspected malignancy; uterine morcellation