Laparoscopic Myomectomy – Converting to Laparotomy for a Suspicious Intraoperative Appearance with Subsequent Benign Histology – a Pre- and Intra-Operative Dilemma
| Autor: | Sarah Wali, Tariq Miskry, Tejal N Amin, Charlotte Porter-Hope |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Leiomyosarcoma
medicine.medical_specialty converting to laparotomy Intra operative medicine.medical_treatment Laparoscopic myomectomy Case Report histology 03 medical and health sciences 0302 clinical medicine Laparotomy Maternity and Midwifery differential diagnosis medicine 030212 general & internal medicine morcellation risks Adenomyoma 030219 obstetrics & reproductive medicine business.industry communication Obstetrics and Gynecology Histology medicine.disease adenomyoma Leiomyoma Oncology Radiology Differential diagnosis business |
| Zdroj: | International Journal of Women's Health |
| ISSN: | 1179-1411 |
| Popis: | Background Although the most common uterine tumour is leiomyoma, the differential diagnoses also include the rarer adenomyoma and leiomyosarcoma. A lack of clear reliable clinical and radiological features makes the triage of uterine masses to the appropriate surgical procedure difficult. In the case of suspicious appearance of a presumed leiomyoma, an open surgical approach is recommended and morcellation is avoided. Case We present a case of a woman undergoing an elective laparoscopic myomectomy for a fibroid that appeared benign on ultrasound but had suspicious features intraoperatively. The operation was converted to a laparotomy to avoid the risk of morcellation-related seeding in the event that the histology was malignant. The histology was subsequently a benign exophytic adenomyoma. Conclusion The assessment of the nature of fibroids can be difficult both pre- and intraoperatively, and the need for difficult decision making to convert to open surgery during a laparoscopic myomectomy but with subsequent benign histology should be part of patient counselling. |
| Databáze: | OpenAIRE |
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