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422 The important criteria for diagnosing uterine sarcoma
  1. NA Umarova,
  2. ZR Sabirdjanova,
  3. ZKh Rakhima and
  4. NR Atadjanova
  1. Citimed Clinic, Medical Academy, NSS Med Centre, Tashkent, Uzbekistan

Abstract

Purpose. Analysis of the results of uterine sarcoma treatment for the purpose of reducing diagnostic errors related to the pathology.

Methodology Materials and methods. The paper discusses a retrospective analysis of materials from clinical and pathoanatomical archives of Republican Specialized Scientific and practical Medical Center of Oncology and Radiology in Uzbekistan, for the period of 2015–2022. Initially, 23 cases of patients with a clinical and morphological diagnosis of uterine sarcoma were selected. The average age was 51.2±1.9.

Results Results. In almost half of the cases – 11 (47.8%), leiomyosarcoma was accompanied by uterine fibroids and in 2 (8.7%) by adenomyosis. Only in 34,8% of cases, the results of separate diagnostic uterine curettage were informative. And, carcinosarcoma was diagnosed in 8,6%, leiomyosarcoma in 17.2%, endometrial stromal sarcoma in 1 (4,3%)case and in another 1 (4,3%) endometrial cancer. Frequent complaint of the patients was: bloody discharge from the genitals – 42.7%. Most patients – 16 (69.5%) had surgery with preoperative diagnosis of uterine fibroids. The remaining underwent surgical interventions with misdiagnosis (ovarian cancer, endometrial cancer, etc). All these indicate the difficulties of clinical and histological diagnosis of malignant non-epithelial tumors of the uterus, often due to insufficient information content of the scraping material and difficulties in their interpretation.

Conclusion Conclusions. Timely diagnosis of uterine sarcoma can be achieved with clinical observation and dynamic ultrasound examination of the pelvis with rapid growth of uterine tumors, especially in pre- and postmenopause. Preoperative diagnosis of leiomyosarcoma by histological examination of scrapings from the uterine cavity is in most cases uninformative. The percentage of diagnostic errors in this pathology can be reduced by comparing a thorough analysis of anamnestic data, clinical course of the disease, gynecological examination with X-ray, instrumental (including hysteroscopy with diagnostic uterine curettage, which is especially valuable for endometrial stromal sarcomas and mixed mesodermal tumors)

Disclosures Legal entity responsible for the study: Nozima Umarova.

Funding: Has not received any funding.

Disclosure: All authors have declared no conflicts of interest.

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