Antonio Macciò1*, Giacomo Chiappe1, Fabrizio Lavra1, Elisabetta Sanna1 and Clelia Madeddu2
1Department of Gynecologic Oncology, Azienda Ospedaliera Brotzu, Italy
2Department of Medical Sciences and Public Health, University of Cagliari, Italy
The weight limit of a uterine mass that can be removed laparoscopically and the possible complications of such a surgery remain unclear.Here, we describe the case of an 80-year-old woman who underwent a minimally invasive approach to a huge uterine mass weighing 11000 grams. Computed tomography showed a large, partially cystic mass undistinguishable from the uterus associated with left hydroureteronephrosis. The patient was advised on the different surgical alternatives, including the possibility of minimally invasive surgery, as well as the risks of morcellation of a potential occult uterine leiomyosarcoma or smooth muscle tumor of uncertain malignant potential, and she opted for a laparoscopic approach if possible. After fluid drainage from the mass, total laparoscopic hysterectomy was performed successfully. Surgery was complicated by ureteral injury that was immediately repaired laparoscopically in the same operative session. Microscopic examination showed a leiomyoma of the uterus with cystic degeneration and calcific content without histologic signs of malignancy.Conclusion: We were able to remove a very large uterus using a minimally invasive approach, reaffirming it is currently impossible to define the maximum uterine weight limit for laparoscopic removal.
Macciò A, Chiappe G, Lavra F, Sanna E, Madeddu C. Removal of a Huge Uterine Mass, Weighing 11000 Grams, In an Elderly Woman with a Minimally Invasive Surgical Approach: Feasibility and Safety. Clin Oncol. 2019; 4: 1596.