Ex abundanti cautela: From the tragedy of inadvertent sarcoma morcellation to inappropriate myoma screening
© The Author(s) 2016
Published: 6 February 2016
The recent commotion about the risk of unexpected malignancy during myoma morcellation may have divergent consequences. Some are positive for future women’s health care, while others may be negative. On the positive side, the ‘sarcoma awareness’ will lead to improvements in the diagnosis of myometrial lesions including leiomyosarcoma and in the technical aspects of safer, ‘spill-free’ myoma removal. On the negative side, the fear of an unexpected sarcoma may lead to unnecessary, more invasive surgery and avoidance of minimal invasive surgery—out of an abundance of caution.
I acknowledge that this simulation based on a few selected publications is simplistic and that the figures are prone to bias. However, I mean it to illustrate the real danger of generalizing partial knowledge in medicine.
The risk of fibroid morcellation is an important women’s health issue and cannot be underestimated. However, it should be put in the right perspective as done by Brölmann et al. . Both blunt denial of the problem and overreaction may have deleterious consequences.
The incidental diagnosis of a fibroid in an asymptomatic woman is rarely an indication for surgery.
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