{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T20:22:36Z","timestamp":1785270156152,"version":"3.55.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>Lynch syndrome (LS) is associated with an increased risk for colorectal, endometrial, and ovarian carcinomas in women. Risk-reducing hysterectomy and bilateral salpingo-oophorectomy (RRHSO) has been shown to be a cost-effective form of management and prevention of gynecological malignancies in patients with LS. Studies of incidental gynecologic malignancies identified in RRHSO are limited. In addition, recommendations on optimal handling of this type of specimen have ranged from submitting for microscopic examination the entire endometrium, fallopian tubes and ovaries to submitting only routine representative sections of these organs. In this study, we present the clinicopathologic findings of 29 cases of LS patients that underwent risk-reducing gynecologic surgery at our institution over a period of 13\u2009yr. Clinical-pathologic information was obtained from the patients\u2019 charts and pathology reports. Significant pathologic abnormalities were identified in 17% (5\/29) of cases, all showing endometrial hyperplasia. Four of them with atypical and 1 without atypical. All of our cases with endometrial pathology had significant findings on preoperative endometrial sampling. To further study the recommendation of in toto submission of the endometrium, ovaries and fallopian tubes and the utility of preoperative endometrial sampling, we undertook a literature review of all the reported cases of incidental pathologic findings identified in RRHSO. The findings of our cohort and the literature reviewed support in toto submission of endometrium, and adnexal structures in the absence of gross lesions. In addition, our findings show a definite benefit for preoperative endometrial sampling as part of the workup for LS patients undergoing RRHSO.<\/jats:p>","DOI":"10.1097\/pgp.0000000000000643","type":"journal-article","created":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T14:00:58Z","timestamp":1576591258000},"page":"313-320","source":"Crossref","is-referenced-by-count":17,"title":["Prophylactic Risk-reducing Hysterectomies and Bilateral Salpingo-oophorectomies in Patients With Lynch Syndrome: A Clinicopathologic Study of 29 Cases and Review of the Literature"],"prefix":"10.1097","volume":"39","author":[{"given":"Faysal A.","family":"Fedda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth D.","family":"Euscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preetha","family":"Ramalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anais","family":"Malpica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,12,16]]},"reference":[{"key":"R1-20230824","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1586\/14737159.2016.1156533","article-title":"Mismatch repair deficiency testing in clinical practice","volume":"16","author":"Buza","year":"2016","journal-title":"Expert Rev Mol Diagn"},{"key":"R2-20230824","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1053\/j.gastro.2009.07.039","article-title":"Calculation of risk of colorectal and endometrial cancer among patients with Lynch syndrome","volume":"137","author":"Stoffel","year":"2009","journal-title":"Gastroenterology"},{"key":"R3-20230824","doi-asserted-by":"crossref","first-page":"e79737","DOI":"10.1371\/journal.pone.0079737","article-title":"Prevalence of Lynch syndrome among patients with newly diagnosed endometrial cancers","volume":"8","author":"Egoavil","year":"2013","journal-title":"PloS One"},{"key":"R4-20230824","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10689-013-9615-1","article-title":"Cancer risk in Lynch syndrome","volume":"12","author":"Barrow","year":"2013","journal-title":"Fam Cancer"},{"key":"R5-20230824","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1097\/01.AOG.0000154885.44002.ae","article-title":"Gynecologic cancer as a \u201csentinel cancer\u201d for women with hereditary nonpolyposis colorectal cancer syndrome","volume":"105","author":"Lu","year":"2005","journal-title":"Obstet Gynecol"},{"key":"R7-20230824","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1056\/NEJMoa052627","article-title":"Prophylactic surgery to reduce the risk of gynecologic cancers in the Lynch syndrome","volume":"354","author":"Schmeler","year":"2006","journal-title":"N Engl J Med"},{"key":"R8-20230824","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/01.AOG.0000267500.27329.85","article-title":"Gynecologic cancer prevention in Lynch syndrome\/hereditary nonpolyposis colorectal cancer families","volume":"110","author":"Chen","year":"2007","journal-title":"Obstet Gynecol"},{"key":"R9-20230824","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.ygyno.2012.08.031","article-title":"Impact of genetic testing on endometrial cancer risk-reducing practices in women at risk for Lynch syndrome","volume":"127","author":"Yurgelun","year":"2012","journal-title":"Gynecol Oncol"},{"key":"R10-20230824","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.ygyno.2013.10.033","article-title":"Prevalence of occult gynecologic malignancy at the time of risk reducing and nonprophylactic surgery in patients with Lynch syndrome","volume":"132","author":"Lachiewicz","year":"2014","journal-title":"Gynecol Oncol"},{"key":"R11-20230824","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1111\/his.12386","article-title":"Review of findings in prophylactic gynaecological specimens in Lynch syndrome with literature review and recommendations for grossing","volume":"65","author":"Downes","year":"2014","journal-title":"Histopathology"},{"key":"R12-20230824","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/PAS.0b013e3182796e27","article-title":"Histologic evaluation of prophylactic hysterectomy and oophorectomy in Lynch syndrome","volume":"37","author":"Karamurzin","year":"2013","journal-title":"Am J Surg Pathol"},{"key":"R13-20230824","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.ygyno.2008.08.002","article-title":"Synchronous occult cancers of the endometrium and fallopian tube in an MSH2 mutation carrier at time of prophylactic surgery","volume":"111","author":"Palma","year":"2008","journal-title":"Gynecol Oncol"},{"key":"R14-20230824","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.pap.0000201826.46978.e5","article-title":"Advances in the recognition of tubal intraepithelial carcinoma: applications to cancer screening and the pathogenesis of ovarian cancer","volume":"13","author":"Lee","year":"2006","journal-title":"Adv Anat Pathol"},{"issue":"suppl 1","key":"R15-20230824","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1097\/PGP.0000000000000552","article-title":"Endometrial carcinoma, grossing and processing issues: recommendations of the International Society of Gynecologic Pathologists","volume":"38","author":"Malpica","year":"2019","journal-title":"Int J Gynecol Pathol"},{"key":"R16-20230824","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1111\/his.13503","article-title":"Intra-operative evaluation of prophylactic hysterectomy and salpingo-oophorectomy specimens in hereditary gynaecological cancer syndromes","volume":"73","author":"Wong","year":"2018","journal-title":"Histopathology"},{"key":"R17-20230824","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1097\/PAS.0000000000000684","article-title":"Pathologic findings in prophylactic and nonprophylactic hysterectomy specimens of patients with Lynch syndrome","volume":"40","author":"Bartosch","year":"2016","journal-title":"Am J Surg Pathol"},{"key":"R18-20230824","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1007\/s003840100349","article-title":"Combined molecular and clinical approach for decision making for surgery in HNPCC patients: a report on three cases in two families","volume":"16","author":"Pistorius","year":"2001","journal-title":"Int J Colorectal Dis"},{"issue":"pt 2","key":"R19-20230824","first-page":"1152","article-title":"Unexpected endometrial cancer at prophylactic hysterectomy in a woman with hereditary nonpolyposis colon cancer","volume":"102","author":"Chung","year":"2003","journal-title":"Obstet Gynecol"},{"key":"R20-20230824","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.ygyno.2005.12.032","article-title":"Occult endometrial cancer and decision making for prophylactic hysterectomy in hereditary nonpolyposis colorectal cancer patients","volume":"102","author":"Pistorius","year":"2006","journal-title":"Gynecol Oncol"},{"key":"R21-20230824","doi-asserted-by":"crossref","first-page":"4793","DOI":"10.1200\/JCO.2009.23.7784","article-title":"Ten years after mutation testing for Lynch syndrome: cancer incidence and outcome in mutation-positive and mutation-negative family members","volume":"27","author":"Jarvinen","year":"2009","journal-title":"J Clin Oncol"},{"key":"R22-20230824","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/PGP.0b013e31824a1dad","article-title":"Are women with endocervical adenocarcinoma at risk for lynch syndrome? Evaluation of 101 cases including unusual subtypes and lower uterine segment tumors","volume":"31","author":"Mills","year":"2012","journal-title":"Int J Gynecol Pathol"},{"key":"R23-20230824","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.ygyno.2015.07.016","article-title":"The gynecological surveillance of women with Lynch syndrome in Sweden","volume":"138","author":"Tzortzatos","year":"2015","journal-title":"Gynecol Oncol"},{"key":"R24-20230824","doi-asserted-by":"crossref","first-page":"613","DOI":"10.3332\/ecancer.2016.613","article-title":"Utility of endometrial sampling prior to risk-reducing hysterectomy in a patient with Lynch syndrome","volume":"10","author":"Frey","year":"2016","journal-title":"Ecancermedicalscience"}],"container-title":["International Journal of Gynecological Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PGP.0000000000000643","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T01:49:37Z","timestamp":1692841777000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PGP.0000000000000643"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,16]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/pgp.0000000000000643","relation":{},"ISSN":["0277-1691"],"issn-type":[{"value":"0277-1691","type":"print"}],"subject":[],"published":{"date-parts":[[2019,12,16]]}}}