Progression of pelvic implants to complex atypical endometrial hyperplasia after uterine morcellation

Obstet Gynecol. 2011 Feb;117(2 Pt 2):447-449. doi: 10.1097/AOG.0b013e3181f2e0c6.

Abstract

Background: Supracervical hysterectomy, a surgical technique that involves removal of the uterus while preserving the cervix, places women at an increased risk for future morbidity.

Case: The patient presented 7 years after laparoscopic supracervical hysterectomy for benign disease, with pelvic pain, urinary frequency, abdominal bloating, and tenderness. Surgical exploration revealed myometrial implants, along with a larger mass on the mesentery of the sigmoid composed of endometrium with complex atypical hyperplasia in a patient without a prior history of complex atypical hyperplasia. The patient was symptom-free 6 months postoperatively.

Conclusion: Histology found during reoperation after laparoscopic supracervical hysterectomy includes endometriosis, residual endometrium, and leiomyomas. In this case, a woman with no prior history of endometrial atypia later developed complex adenomatous endometrial hyperplasia in a peritoneal implant. This finding adds to the list of possible complications after laparoscopic-assisted supracervical hysterectomy and uterine morcellation.

Publication types

  • Case Reports

MeSH terms

  • Endometrial Hyperplasia / etiology*
  • Endometrial Hyperplasia / pathology*
  • Endometrial Hyperplasia / surgery
  • Endometriosis / etiology*
  • Endometriosis / pathology*
  • Endometriosis / surgery
  • Female
  • Humans
  • Hysterectomy / adverse effects*
  • Leiomyoma / pathology
  • Middle Aged
  • Prostheses and Implants / adverse effects*
  • Treatment Outcome
  • Uterine Neoplasms / pathology