Book contents
- Modern Management of Uterine Fibroids
- Modern Management of Uterine Fibroids
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Pathophysiology of Uterine Fibroids
- Chapter 2 Evaluation of Uterine Fibroids Using Two-Dimensional and Three-Dimensional Ultrasonography
- Chapter 3 Ulipristal and Other Medical Interventions for Treatment of Uterine Fibroids
- Chapter 4 The Role of Magnetic Resonance Imaging in the Management of Fibroids
- Chapter 5 Fibroids and Fertility
- Chapter 6 Fibroids and Reproduction
- Chapter 7 Open Myomectomy
- Chapter 8 Laparoscopic and Robotic Myomectomy
- Chapter 9 Principles and Technique of Laparoscopic Myomectomy
- Chapter 10 Uterine Fibroids
- Chapter 11 Total Laparoscopic Hysterectomy for the Fibroid Uterus
- Chapter 12 Hysteroscopic Resection of Submucosal Fibroids
- Chapter 13 Modern Management of Intramural Myomas
- Chapter 14 Outpatient Myomectomy
- Chapter 15 Vaginal Hysterectomy with Fibroids
- Chapter 16 Leiomyosarcoma
- Chapter 17 MRI-Guided Ultrasound Lysis of Fibroids
- Chapter 18 Embolization for the Management of Uterine Fibroids
- Chapter 19 Uterine Fibroids in Postmenopausal Women
- Appendix: Video Captions
- Index
- References
Chapter 16 - Leiomyosarcoma
Implications for the Treatment of Fibroids
Published online by Cambridge University Press: 10 October 2020
- Modern Management of Uterine Fibroids
- Modern Management of Uterine Fibroids
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Pathophysiology of Uterine Fibroids
- Chapter 2 Evaluation of Uterine Fibroids Using Two-Dimensional and Three-Dimensional Ultrasonography
- Chapter 3 Ulipristal and Other Medical Interventions for Treatment of Uterine Fibroids
- Chapter 4 The Role of Magnetic Resonance Imaging in the Management of Fibroids
- Chapter 5 Fibroids and Fertility
- Chapter 6 Fibroids and Reproduction
- Chapter 7 Open Myomectomy
- Chapter 8 Laparoscopic and Robotic Myomectomy
- Chapter 9 Principles and Technique of Laparoscopic Myomectomy
- Chapter 10 Uterine Fibroids
- Chapter 11 Total Laparoscopic Hysterectomy for the Fibroid Uterus
- Chapter 12 Hysteroscopic Resection of Submucosal Fibroids
- Chapter 13 Modern Management of Intramural Myomas
- Chapter 14 Outpatient Myomectomy
- Chapter 15 Vaginal Hysterectomy with Fibroids
- Chapter 16 Leiomyosarcoma
- Chapter 17 MRI-Guided Ultrasound Lysis of Fibroids
- Chapter 18 Embolization for the Management of Uterine Fibroids
- Chapter 19 Uterine Fibroids in Postmenopausal Women
- Appendix: Video Captions
- Index
- References
Summary
The risk of finding an occult leiomyosarcoma (LMS) at surgery for presumed leiomyomas and subsequent outcomes for patients who have these tumours morcellated is a subject of conflict in gynaecology today. This dispute arose in 2013 from a single case in which a physician underwent surgery for fibroids and power morcellation was utilized. This physician ultimately was diagnosed with an LMS and she and her family began a media campaign and created a public forum to effect a ban on power morcellation. They argued that prevalence of these occult tumours was much higher than originally believed, and the use of power morcellation worsened outcomes. Originally, a friend of the physician performed a cursory meta-analysis using incomplete data suggesting that the rate of uterine sarcoma in women having surgery for presumed fibroids was 1 in 323. The US Food and Drug Administration (FDA) used similar but slightly different methodology and found a prevalence of 1 in 352 for uterine sarcoma, and 1 in 498 for leiomyosarcoma [1]. Neither analysis has been published in a peer-reviewed journal, and both represent incomplete and biased attempts at establishing a prevalence rate.
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- Modern Management of Uterine Fibroids , pp. 155 - 164Publisher: Cambridge University PressPrint publication year: 2020