Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 2/2018

24.11.2017 | General Gynecology

Ultrasound guided core needle biopsy prior to thermo ablative treatment of uterine tumors: first results

verfasst von: Christina B. Walter, Andreas D. Hartkopf, Dorit Schoeller, Bernhard Kraemer, Felix Neis, Florin-Andrei Taran, Keith B. Isaacson, Sara Y. Brucker, Markus Hahn

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study aimed at evaluating the diagnostic yield for core needle biopsies of uterine fibroids before laparoscopic radiofrequency volumetric thermal ablation (RFVTA) with the aim of sonographic imaging. This study was in the context of a randomized, prospective, single-center, longitudinal comparative study in which RFVTA and laparoscopic myomectomy for symptomatic uterine fibroids were compared.

Methods

All patients of the RFVTA-arm received a core needle biopsy under the guidance of an intraoperative laparoscopic ultrasound system. The Tissue samples were observed histologically.

Results

24 patients were included and received in the median 3.17 biopsies (range 2–7). 45.8% of the fibroids were intramural. In 92% uterine leiomyoma was detected, in 4% a cell rich leiomyoma and in 4% a smooth muscle tumor with uncertain malignant potential (STUMP). There were no complications caused by core needle biopsy.

Conclusions

Ultrasound guided core needle biopsy can be used to receive a histological result before treating uterine fibroids with thermo surgical methods like RFVTA.
Literatur
1.
Zurück zum Zitat Stang A, Merrill RM, Kuss O (2011) Hysterectomy in Germany: a DRG-based nationwide analysis, 2005–2006. Deutsch Arzteblatt Int 108(30):508–514 Stang A, Merrill RM, Kuss O (2011) Hysterectomy in Germany: a DRG-based nationwide analysis, 2005–2006. Deutsch Arzteblatt Int 108(30):508–514
2.
Zurück zum Zitat Cramer SF, Patel A (1990) The frequency of uterine leiomyomas. Am J Clin Pathol 94(4):435–438CrossRefPubMed Cramer SF, Patel A (1990) The frequency of uterine leiomyomas. Am J Clin Pathol 94(4):435–438CrossRefPubMed
3.
Zurück zum Zitat Holzer A, Jirecek ST, Illievich UM, Huber J, Wenzl RJ (2006) Laparoscopic versus open myomectomy: a double-blind study to evaluate postoperative pain. Anesth Analg 102(5):1480–1484CrossRefPubMed Holzer A, Jirecek ST, Illievich UM, Huber J, Wenzl RJ (2006) Laparoscopic versus open myomectomy: a double-blind study to evaluate postoperative pain. Anesth Analg 102(5):1480–1484CrossRefPubMed
4.
Zurück zum Zitat Kainsbak J, Hansen ES, Dueholm M (2015) Literature review of outcomes and prevalence and case report of leiomyosarcomas and non-typical uterine smooth muscle leiomyoma tumors treated with uterine artery embolization. Eur J Obstet Gynecol Reprod Biol 191:130–137CrossRefPubMed Kainsbak J, Hansen ES, Dueholm M (2015) Literature review of outcomes and prevalence and case report of leiomyosarcomas and non-typical uterine smooth muscle leiomyoma tumors treated with uterine artery embolization. Eur J Obstet Gynecol Reprod Biol 191:130–137CrossRefPubMed
5.
Zurück zum Zitat Brucker SY, Hahn M, Kraemer D, Taran FA, Isaacson KB, Kramer B (2014) Laparoscopic radiofrequency volumetric thermal ablation of fibroids versus laparoscopic myomectomy. Int J Gynaecol Obstet 125(3):261–265CrossRefPubMed Brucker SY, Hahn M, Kraemer D, Taran FA, Isaacson KB, Kramer B (2014) Laparoscopic radiofrequency volumetric thermal ablation of fibroids versus laparoscopic myomectomy. Int J Gynaecol Obstet 125(3):261–265CrossRefPubMed
6.
Zurück zum Zitat Brolmann H, Tanos V, Grimbizis G, Ind T, Philips K, van den Bosch T et al (2015) Options on fibroid morcellation: a literature review. Gynecol Surg 12(1):3–15CrossRefPubMedPubMedCentral Brolmann H, Tanos V, Grimbizis G, Ind T, Philips K, van den Bosch T et al (2015) Options on fibroid morcellation: a literature review. Gynecol Surg 12(1):3–15CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Dueholm M, Lundorf E, Hansen ES, Ledertoug S, Olesen F (2002) Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas. Am J Obstet Gynecol 186(3):409–415CrossRefPubMed Dueholm M, Lundorf E, Hansen ES, Ledertoug S, Olesen F (2002) Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas. Am J Obstet Gynecol 186(3):409–415CrossRefPubMed
8.
Zurück zum Zitat Exacoustos C, Romanini ME, Amadio A, Amoroso C, Szabolcs B, Zupi E et al (2007) Can gray-scale and color Doppler sonography differentiate between uterine leiomyosarcoma and leiomyoma? J Clin Ultrasound 35(8):449–457CrossRefPubMed Exacoustos C, Romanini ME, Amadio A, Amoroso C, Szabolcs B, Zupi E et al (2007) Can gray-scale and color Doppler sonography differentiate between uterine leiomyosarcoma and leiomyoma? J Clin Ultrasound 35(8):449–457CrossRefPubMed
9.
Zurück zum Zitat Namimoto T, Yamashita Y, Awai K, Nakaura T, Yanaga Y, Hirai T et al (2009) Combined use of T2-weighted and diffusion-weighted 3-T MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol 19(11):2756–2764CrossRefPubMed Namimoto T, Yamashita Y, Awai K, Nakaura T, Yanaga Y, Hirai T et al (2009) Combined use of T2-weighted and diffusion-weighted 3-T MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol 19(11):2756–2764CrossRefPubMed
10.
Zurück zum Zitat Samuel A, Fennessy FM, Tempany CM, Stewart EA (2008) Avoiding treatment of leiomyosarcomas: the role of magnetic resonance in focused ultrasound surgery. Fertil Steril 90(3):850, e9–e12CrossRef Samuel A, Fennessy FM, Tempany CM, Stewart EA (2008) Avoiding treatment of leiomyosarcomas: the role of magnetic resonance in focused ultrasound surgery. Fertil Steril 90(3):850, e9–e12CrossRef
11.
Zurück zum Zitat Zhang HJ, Zhan FH, Li YJ, Sun HR, Bai RJ, Gao S (2011) Fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging of uterine leiomyosarcomas: 2 cases report. Chin Med J (Engl) 124(14):2237–2240 Zhang HJ, Zhan FH, Li YJ, Sun HR, Bai RJ, Gao S (2011) Fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging of uterine leiomyosarcomas: 2 cases report. Chin Med J (Engl) 124(14):2237–2240
12.
Zurück zum Zitat Nam JH, Park JY (2010) Update on treatment of uterine sarcoma. Curr Opin Obstet Gynecol 22(1):36–42CrossRefPubMed Nam JH, Park JY (2010) Update on treatment of uterine sarcoma. Curr Opin Obstet Gynecol 22(1):36–42CrossRefPubMed
13.
14.
Zurück zum Zitat Beckmann MW, Juhasz-Boss I, Denschlag D, Gass P, Dimpfl T, Harter P et al (2015) Surgical methods for the treatment of uterine fibroids—risk of uterine sarcoma and problems of morcellation: position paper of the DGGG. Geburtshilfe Frauenheilkd 75(2):148–164CrossRefPubMedPubMedCentral Beckmann MW, Juhasz-Boss I, Denschlag D, Gass P, Dimpfl T, Harter P et al (2015) Surgical methods for the treatment of uterine fibroids—risk of uterine sarcoma and problems of morcellation: position paper of the DGGG. Geburtshilfe Frauenheilkd 75(2):148–164CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Bonvalot S, Rivoire M, Castaing M, Stoeckle E, Le Cesne A, Blay JY et al (2009) Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol 27(1):31–37CrossRefPubMed Bonvalot S, Rivoire M, Castaing M, Stoeckle E, Le Cesne A, Blay JY et al (2009) Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol 27(1):31–37CrossRefPubMed
16.
Zurück zum Zitat Shen MY, Huang IP, Chen WS, Chang JT, Lin JK (2008) Influence of pneumoperitoneum on tumor growth and pattern of intra-abdominal tumor spreading: in vivo study of a murine model. Hepatogastroenterology 55(84):947–951PubMed Shen MY, Huang IP, Chen WS, Chang JT, Lin JK (2008) Influence of pneumoperitoneum on tumor growth and pattern of intra-abdominal tumor spreading: in vivo study of a murine model. Hepatogastroenterology 55(84):947–951PubMed
17.
Zurück zum Zitat Binda MM, Corona R, Amant F, Koninckx PR (2014) Conditioning of the abdominal cavity reduces tumor implantation in a laparoscopic mouse model. Surg Today 44(7):1328–1335CrossRefPubMedPubMedCentral Binda MM, Corona R, Amant F, Koninckx PR (2014) Conditioning of the abdominal cavity reduces tumor implantation in a laparoscopic mouse model. Surg Today 44(7):1328–1335CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Peng Y, Yang H, Ye Q, Zhou H, Zheng M, Shi Y (2017) Inhibition of peritoneal dissemination of colon cancer by hyperthermic CO2 insufflation: a novel approach to prevent intraperitoneal tumor spread. PLoS One 12(2):e0172097CrossRefPubMedPubMedCentral Peng Y, Yang H, Ye Q, Zhou H, Zheng M, Shi Y (2017) Inhibition of peritoneal dissemination of colon cancer by hyperthermic CO2 insufflation: a novel approach to prevent intraperitoneal tumor spread. PLoS One 12(2):e0172097CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Prayson RA, Hart WR (1995) Pathologic considerations of uterine smooth muscle tumors. Obstet Gynecol Clin North Am 22(4):637–657PubMed Prayson RA, Hart WR (1995) Pathologic considerations of uterine smooth muscle tumors. Obstet Gynecol Clin North Am 22(4):637–657PubMed
20.
Zurück zum Zitat Taran FA, Weaver AL, Gostout BS, Stewart EA (2010) Understanding cellular leiomyomas: a case-control study. Am J Obstet Gynecol 203(2):109, e1–e6CrossRef Taran FA, Weaver AL, Gostout BS, Stewart EA (2010) Understanding cellular leiomyomas: a case-control study. Am J Obstet Gynecol 203(2):109, e1–e6CrossRef
21.
Zurück zum Zitat Hodge JC, Pearce KE, Clayton AC, Taran FA, Stewart EA (2014) Uterine cellular leiomyomata with chromosome 1p deletions represent a distinct entity. Am J Obstet Gynecol. 210(6):572, e1–e7CrossRef Hodge JC, Pearce KE, Clayton AC, Taran FA, Stewart EA (2014) Uterine cellular leiomyomata with chromosome 1p deletions represent a distinct entity. Am J Obstet Gynecol. 210(6):572, e1–e7CrossRef
22.
Zurück zum Zitat Ly A, Mills AM, McKenney JK, Balzer BL, Kempson RL, Hendrickson MR et al (2013) Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. Am J Surg Pathol 37(5):643–649CrossRefPubMed Ly A, Mills AM, McKenney JK, Balzer BL, Kempson RL, Hendrickson MR et al (2013) Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. Am J Surg Pathol 37(5):643–649CrossRefPubMed
23.
Zurück zum Zitat Papadia A, Salom EM, Fulcheri E, Ragni N (2007) Uterine sarcoma occurring in a premenopausal patient after uterine artery embolization: a case report and review of the literature. Gynecol Oncol 104(1):260–263CrossRefPubMed Papadia A, Salom EM, Fulcheri E, Ragni N (2007) Uterine sarcoma occurring in a premenopausal patient after uterine artery embolization: a case report and review of the literature. Gynecol Oncol 104(1):260–263CrossRefPubMed
Metadaten
Titel
Ultrasound guided core needle biopsy prior to thermo ablative treatment of uterine tumors: first results
verfasst von
Christina B. Walter
Andreas D. Hartkopf
Dorit Schoeller
Bernhard Kraemer
Felix Neis
Florin-Andrei Taran
Keith B. Isaacson
Sara Y. Brucker
Markus Hahn
Publikationsdatum
24.11.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2018
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-017-4590-7

Weitere Artikel der Ausgabe 2/2018

Archives of Gynecology and Obstetrics 2/2018 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.