Hysteroscopic endomyometrial resection of three uterine sarcomas

Study Objective. To describe our experience with three uterine sarcomas associated with hysteroscopic endometrial ablation. Design. Cohort study (Canadian Task Force classification II-2). Setting. University-affiliated teaching hospitals. Patients. Three of 2402 women undergoing hysteroscopic endometrial ablation who had uterine sarcomas. Intervention. Hysteroscopic endomyometrial resection. Measurements and Main Results. One low-grade endometrial stromal sarcoma and two carcinosarcomas were resected. After hysterectomy in two patients, no residual cancer was identified in one of them. The third patient was an 82-year-old woman with moderate menorrhagia who refused hysterectomy. After endomyometrial resection she remained amenorrheic for the last 14 months of her life. Conclusion. From our experience the incidence of uterine sarcomas is approximately 1/800 women undergoing hysteroscopic ablation for abnormal uterine bleeding. Complete endomyometrial resection is feasible and may be offered as diagnostic and palliative therapy in women at high risk for hysterectomy.