{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:46:58Z","timestamp":1761562018735},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,8,28]],"date-time":"2015-08-28T00:00:00Z","timestamp":1440720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Morcellation for tissue extraction during laparoscopic hysterectomy or myomectomy has recently been questioned because of the potential to spread occult uterine cancers. The Australian Therapeutic Goods Administration (<jats:styled-content style=\"fixed-case\">TGA<\/jats:styled-content>) issued a safety advisory in August 2014, estimating the risk of occult malignancy in the Australian population to be one in 1000 or lower, based on estimates from overseas studies in the absence of any local data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to determine the incidence of occult uterine malignancies in morcellated surgical specimens at St John of God Hospital in Perth, Western Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>All women who had a hysterectomy or myomectomy with morcellation of the surgical specimen for presumed benign uterine fibroids at our institution from 01 November 2009 to 12 March 2015 were identified and stratified into benign disease, uncertain malignant potential and malignant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven hundred and thirty\u2010four women were included, and three malignancies were identified: two cases with leiomyosarcoma (<jats:styled-content style=\"fixed-case\">LMS<\/jats:styled-content>) and another with an endometrioid endometrial adenocarcinoma (<jats:styled-content style=\"fixed-case\">EAC<\/jats:styled-content>). One case of serous tubal in\u00a0situ carcinoma (<jats:styled-content style=\"fixed-case\">STIC<\/jats:styled-content>) and two cases of benign metastasising leiomyoma\/leiomyomatosis were also identified. The overall risk of malignancy in a morcellated surgical specimen was 0.41% (three in 734). The risk of morcellating an incidental uterine malignancy was 0.27% for <jats:styled-content style=\"fixed-case\">LMS<\/jats:styled-content> and 0.14% for <jats:styled-content style=\"fixed-case\">EAC<\/jats:styled-content>. All three incidental malignancies were diagnosed in premenopausal women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The risk of unintended morcellation of uterine malignancy in our study is higher than that estimated by the Australian <jats:styled-content style=\"fixed-case\">TGA<\/jats:styled-content> and highlights the urgent need for further studies in Australia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12401","type":"journal-article","created":{"date-parts":[[2015,8,28]],"date-time":"2015-08-28T14:01:13Z","timestamp":1440770473000},"page":"503-506","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Morcellation of occult uterine malignancies: an <scp>A<\/scp>ustralian single institution retrospective study"],"prefix":"10.1111","volume":"55","author":[{"given":"Adeline","family":"Tan","sequence":"first","affiliation":[{"name":"St John of God Hospital Subiaco Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Salfinger","sequence":"additional","affiliation":[{"name":"St John of God Hospital Subiaco Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Tan","sequence":"additional","affiliation":[{"name":"St John of God Hospital Subiaco Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Cohen","sequence":"additional","affiliation":[{"name":"St John of God Hospital Subiaco Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000136079.62513.39"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1209993"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.02.008"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28959"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/IGC.0b013e31819a1f8f"},{"key":"e_1_2_7_7_1","unstructured":"Tissue Extraction at Minimally Invasive Procedures. Statement developed by the AGES society and ratified by the AGES Board in May 2014. This statement was reviewed by the Women's Health Committee and approved by the RANZCOG Board and Council. [Accessed 30th January 2015] Available from URL:http:\/\/www.ranzcog.edu.au"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000010172"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28844"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.04.021"},{"key":"e_1_2_7_11_1","unstructured":"Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication April 17th 2014. [Accessed 30th January 2015] Available from URL:http:\/\/www.fda.gov\/MedicalDevices\/Safety\/AlertsandNotices\/ucm393576.htm"},{"key":"e_1_2_7_12_1","unstructured":"Updated Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication November 24th 2014. [Accessed 6th February 2015] Available from URL:http:\/\/www.fda.gov\/MedicalDevices\/Safety\/AlertsandNotices\/ucm424443.htm"},{"key":"e_1_2_7_13_1","unstructured":"Laparoscopic power morcellators\u2010 update 4 August 2014. Safety advisory \u2010 update following Urogynaecological Devices Working Group advice. 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