Prevalence of unexpected malignant disease in the histopathology of hysterectomy indicated for benign condition

Isabela Sanchez Mayorca, Angela María Gómez Forero, Roberto Gallo Roa, Camilo Alberto Garzón Sarmiento
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Abstract

Objective: To describe the prevalence of incidental malignant pathology following a hysterectomy performed for benign reasons.

Method: A descriptive cross-sectional study based on hospital records. Women who underwent hysterectomy for benign reasons at a general referral hospital between 2013 and 2021 were included. Women with obstetric hysterectomy were excluded. Measured variables: age, route of hysterectomy, type of hysterectomy, histopathological diagnosis of premalignant lesion or invasive cancer, type of cancer. Analysis: Descriptive, the prevalence of preneoplastic and neoplastic conditions was estimated for the overall period.

Results: Of 816 clinical records, 674 cases (87 %) met the inclusion criteria and were analyzed. The premenopausal population predominated. Twentysix cases of unexpected malignant disease were identified, yielding a prevalence of 3.8 %, and 13 cases of premalignant pathology (1.9 %). The most common origin was the cervix (40 %), followed by the ovary (33 %).

Conclusions: Patients undergoing hysterectomy for benign conditions should be informed about the risk of unexpected injury. The importance of performing, in our context an adequate preoperative approach to rule out cervix uteri and ovarian cancer is emphasized. Follow-up studies of patients with unanticipated cancer are required to determine their treatment and prognosis in the region.

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[良性子宫切除术组织病理学中未预期的恶性疾病的发生率]。
目的:描述良性子宫切除术后偶发恶性病变的发生率。方法:基于医院记录的描述性横断面研究。研究对象包括 2013 年至 2021 年期间在一家综合转诊医院因良性原因接受子宫切除术的女性。不包括产科子宫切除术的妇女。测量变量:年龄、子宫切除术的途径、子宫切除术的类型、组织病理学诊断为恶性前病变或浸润性癌症、癌症类型。结果:从 816 份临床记录中分析了符合纳入标准的 674 个病例(87%)。绝经前人群占多数。共发现 26 例未预见到的恶性疾病,发病率为 3.8%,13 例恶性肿瘤前病变(1.9%)。结论:因良性疾病接受子宫切除术的患者应考虑报告意外病变的风险。结论:因良性疾病而接受子宫切除术的患者应考虑到报告意外病变的风险,强调充分的术前处理的重要性,尤其是在我们的环境中排除卵巢癌和宫颈癌的可能性。需要对意外癌症患者进行随访研究,以确定该地区的治疗方法和预后。
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