Description of Event or Problem · 1
(B)(6) OLD WHITE WOMAN WITH HX UTERINE LEIOMYOMA UNDERWENT LAPAROSCOPIC HYSTERECTOMY WITH IN SITU MORCELLATION. SURGERY WAS PERFORMED BY (B)(6) AT (B)(6). PATHOLOGICAL EXAM FOUND INCIDENTAL GRADE 3B LEIOMYOSARCOMA. WITHIN A FEW MONTHS IT WAS WIDELY METASTASIZED WITH NUMEROUS LOCAL RECURRENCES IN THE ABDOMEN. PT UNDERWENT SEVERAL COURSE OF CHEMOTHERAPY (GEM/TAX, DOXORUBICIN, DACARBAZINE) TO WHICH DISTANT METASTASES RESPONDED WELL. ATTEMPT AT SURGICAL DEBULKING FAILED BECAUSE OF DIFFUSE TUMOR SPREADING THROUGHOUT ABDOMEN. SHE DIED 19 MONTHS AFTER THE HYSTERECTOMY. MORCELLATION OF THE UTERUS MOST LIKELY WAS RESPONSIBLE FOR THE STRONG LOCAL RECURRENCES OF THE CANCER AND THE SHORT POSTOP SURVIVAL TIME. PAIN WAS SEVERE TOWARD THE END OF HER LIFE. GUIDELINES FOR UTERINE MORCELLATION NEED TO BE REVISED. PTS MUST BE BETTER INFORMED AS TO RISKS AND OLDER WOMEN WITH HIGHER PROBABILITY OF OCCULT CANCER SHOULD NOT BE CANDIDATES.