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Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms.

Abstract Power morcellation has become a common technique for the minimally invasive resection of uterine leiomyomas. This technique is associated with dissemination of cellular material throughout the peritoneum. When morcellated uterine tumors are unexpectedly found to be leiomyosarcomas or tumors with atypical features (atypical leiomyoma, smooth muscle tumor of uncertain malignant potential), there may be significant clinical consequences. This study was undertaken to determine the frequency and clinical consequence of intraperitoneal dissemination of these neoplasms.
PMID
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Authors

Mayor MeshTerms

Neoplasm Seeding

Keywords
Journal Title plos one
Publication Year Start
%A Seidman, Michael A.; Oduyebo, Titilope; Muto, Michael G.; Crum, Christopher P.; Nucci, Marisa R.; Quade, Bradley J.
%T Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms.
%J PloS one, vol. 7, no. 11, p. e50058
%D 11/2012
%V 7
%N 11
%M eng
%B Power morcellation has become a common technique for the minimally invasive resection of uterine leiomyomas. This technique is associated with dissemination of cellular material throughout the peritoneum. When morcellated uterine tumors are unexpectedly found to be leiomyosarcomas or tumors with atypical features (atypical leiomyoma, smooth muscle tumor of uncertain malignant potential), there may be significant clinical consequences. This study was undertaken to determine the frequency and clinical consequence of intraperitoneal dissemination of these neoplasms.
%K Adult, Female, Humans, Leiomyoma, Leiomyosarcoma, Neoplasm Seeding, Peritoneum, Uterine Neoplasms
%P e50058
%Y 10.1371/journal.pone.0050058
%W PHY
%G AUTHOR
%R 2012PLoSO...7....0S

@Article{Seidman2012,
author="Seidman, Michael A.
and Oduyebo, Titilope
and Muto, Michael G.
and Crum, Christopher P.
and Nucci, Marisa R.
and Quade, Bradley J.",
title="Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms.",
journal="PloS one",
year="2012",
month="Nov",
day="26",
volume="7",
number="11",
pages="e50058",
keywords="Adult",
keywords="Female",
keywords="Humans",
keywords="Leiomyoma",
keywords="Leiomyosarcoma",
keywords="Neoplasm Seeding",
keywords="Peritoneum",
keywords="Uterine Neoplasms",
abstract="Power morcellation has become a common technique for the minimally invasive resection of uterine leiomyomas. This technique is associated with dissemination of cellular material throughout the peritoneum. When morcellated uterine tumors are unexpectedly found to be leiomyosarcomas or tumors with atypical features (atypical leiomyoma, smooth muscle tumor of uncertain malignant potential), there may be significant clinical consequences. This study was undertaken to determine the frequency and clinical consequence of intraperitoneal dissemination of these neoplasms.",
issn="1932-6203",
doi="10.1371/journal.pone.0050058",
url="http://www.ncbi.nlm.nih.gov/pubmed/23189178",
language="eng"
}

%0 Journal Article
%T Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms.
%A Seidman, Michael A.
%A Oduyebo, Titilope
%A Muto, Michael G.
%A Crum, Christopher P.
%A Nucci, Marisa R.
%A Quade, Bradley J.
%J PloS one
%D 2012
%8 November 26
%V 7
%N 11
%@ 1932-6203
%G eng
%F Seidman2012
%X Power morcellation has become a common technique for the minimally invasive resection of uterine leiomyomas. This technique is associated with dissemination of cellular material throughout the peritoneum. When morcellated uterine tumors are unexpectedly found to be leiomyosarcomas or tumors with atypical features (atypical leiomyoma, smooth muscle tumor of uncertain malignant potential), there may be significant clinical consequences. This study was undertaken to determine the frequency and clinical consequence of intraperitoneal dissemination of these neoplasms.
%K Adult
%K Female
%K Humans
%K Leiomyoma
%K Leiomyosarcoma
%K Neoplasm Seeding
%K Peritoneum
%K Uterine Neoplasms
%U http://dx.doi.org/10.1371/journal.pone.0050058
%U http://www.ncbi.nlm.nih.gov/pubmed/23189178
%P e50058

PT Journal
AU Seidman, MA
   Oduyebo, T
   Muto, MG
   Crum, CP
   Nucci, MR
   Quade, BJ
TI Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms.
SO PloS one
JI PLoS ONE
PD 11
PY 2012
BP e50058
VL 7
IS 11
DI 10.1371/journal.pone.0050058
LA eng
DE Adult; Female; Humans; Leiomyoma; Leiomyosarcoma; Neoplasm Seeding; Peritoneum; Uterine Neoplasms
AB Power morcellation has become a common technique for the minimally invasive resection of uterine leiomyomas. This technique is associated with dissemination of cellular material throughout the peritoneum. When morcellated uterine tumors are unexpectedly found to be leiomyosarcomas or tumors with atypical features (atypical leiomyoma, smooth muscle tumor of uncertain malignant potential), there may be significant clinical consequences. This study was undertaken to determine the frequency and clinical consequence of intraperitoneal dissemination of these neoplasms.
ER

PMID- 23189178
OWN - NLM
STAT- MEDLINE
DA  - 20121128
DCOM- 20130516
LR  - 20150219
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 7
IP  - 11
DP  - 2012
TI  - Peritoneal dissemination complicating morcellation of uterine mesenchymal
      neoplasms.
PG  - e50058
LID - 10.1371/journal.pone.0050058 [doi]
AB  - BACKGROUND: Power morcellation has become a common technique for the minimally
      invasive resection of uterine leiomyomas. This technique is associated with
      dissemination of cellular material throughout the peritoneum. When morcellated
      uterine tumors are unexpectedly found to be leiomyosarcomas or tumors with
      atypical features (atypical leiomyoma, smooth muscle tumor of uncertain malignant
      potential), there may be significant clinical consequences. This study was
      undertaken to determine the frequency and clinical consequence of intraperitoneal
      dissemination of these neoplasms. METHODOLOGY/PRINCIPAL FINDINGS: From 2005-2010,
      1091 instances of uterine morcellation were identified at BWH. Unexpected
      diagnoses of leiomyoma variants or atypical and malignant smooth muscle tumors
      occurred in 1.2% of cases using power morcellation for uterine masses clinically 
      presumed to be "fibroids" over this period, including one endometrial stromal
      sarcoma (ESS), one cellular leiomyoma (CL), six atypical leiomyomas (AL), three
      smooth muscle tumor of uncertain malignant potential (STUMPs), and one
      leiomyosarcoma (LMS). The rate of unexpected sarcoma after the laparoscopic
      morcellation procedure was 0.09%, 9-fold higher than the rate currently quoted to
      patients during pre-procedure briefing, and this rate may increase over time as
      diagnostically challenging or under-sampled tumors manifest their biological
      potential. Furthermore, when examining follow-up laparoscopies, both from
      in-house and consultation cases, disseminated disease occurred in 64.3% of all
      tumors (zero of one ESS, one of one CL, zero of one AL, four of four STUMPs, and 
      four of seven LMS). Only disseminated leiomyosarcoma, however, was associated
      with mortality. Procedures are proposed for pathologic evaluation of morcellation
      specimens and associated follow-up specimens. CONCLUSIONS/SIGNIFICANCE: While
      additional study is warranted, these data suggest uterine morcellation carries a 
      risk of disseminating unexpected malignancy with apparent associated increase in 
      mortality much higher than appreciated currently.
FAU - Seidman, Michael A
AU  - Seidman MA
AD  - Division of Women's and Perinatal Pathology, Department of Pathology, Brigham &
      Women's Hospital/Harvard Medical School, Boston, Massachussetts, United States of
      America. [email protected]
FAU - Oduyebo, Titilope
AU  - Oduyebo T
FAU - Muto, Michael G
AU  - Muto MG
FAU - Crum, Christopher P
AU  - Crum CP
FAU - Nucci, Marisa R
AU  - Nucci MR
FAU - Quade, Bradley J
AU  - Quade BJ
LA  - eng
PT  - Journal Article
DEP - 20121126
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Leiomyoma/pathology/surgery
MH  - Leiomyosarcoma/pathology/surgery
MH  - *Neoplasm Seeding
MH  - Peritoneum/*pathology
MH  - Uterine Neoplasms/diagnosis/*pathology/surgery
PMC - PMC3506532
OID - NLM: PMC3506532
EDAT- 2012/11/29 06:00
MHDA- 2013/05/17 06:00
CRDT- 2012/11/29 06:00
PHST- 2012/08/22 [received]
PHST- 2012/10/15 [accepted]
PHST- 2012/11/26 [epublish]
AID - 10.1371/journal.pone.0050058 [doi]
AID - PONE-D-12-25818 [pii]
PST - ppublish
SO  - PLoS One. 2012;7(11):e50058. doi: 10.1371/journal.pone.0050058. Epub 2012 Nov 26.

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