Progression of Pelvic Implants to Complex Atypical Endometrial Hyperplasia After Uterine Morcellation

Lisa M. Kill, Kill LM, Vasilis Kapetanakis, Kapetanakis V, McCullough AE, Ann E. McCullough, Javier F. Magrina, Magrina JF
Obstetrics and gynecology · 2011 · vol. 117(2) , pp. 447–449 · doi:10.1097/aog.0b013e3181f2e0c6 · PMID:21252784 · W2329544695
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This case report describes a patient who developed complex atypical endometrial hyperplasia in a peritoneal implant seven years after a supracervical hysterectomy with uterine morcellation.

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This case report describes a patient who developed complex atypical endometrial hyperplasia within pelvic implants seven years after undergoing laparoscopic supracervical hysterectomy with uterine morcellation for benign disease. Surgical exploration revealed myometrial implants and a sigmoid mesentery mass containing endometrial tissue with complex atypical hyperplasia, despite the patient having no prior history of such atypia. The authors conclude that histological findings during reoperation may include endometriosis, residual endometrium, or leiomyomas, highlighting this condition as a potential complication of the initial surgical procedure. Relevance to endometriosis: This paper is centrally about endometriosis — specifically the malignant transformation of peritoneal endometriotic implants following uterine morcellation.

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Abstract

BACKGROUND: Supracervical hysterectomy, a surgical technique that involves removal of the uterus while preserving the cervix, places women at an increased risk for future morbidity. CASE: The patient presented 7 years after laparoscopic supracervical hysterectomy for benign disease, with pelvic pain, urinary frequency, abdominal bloating, and tenderness. Surgical exploration revealed myometrial implants, along with a larger mass on the mesentery of the sigmoid composed of endometrium with complex atypical hyperplasia in a patient without a prior history of complex atypical hyperplasia. The patient was symptom-free 6 months postoperatively. CONCLUSION: Histology found during reoperation after laparoscopic supracervical hysterectomy includes endometriosis, residual endometrium, and leiomyomas. In this case, a woman with no prior history of endometrial atypia later developed complex adenomatous endometrial hyperplasia in a peritoneal implant. This finding adds to the list of possible complications after laparoscopic-assisted supracervical hysterectomy and uterine morcellation.
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Background

Supracervical hysterectomy, a surgical technique that involves removal of the uterus while preserving the cervix, places women at an increased risk for future morbidity. CASE: The patient presented 7 years after laparoscopic supracervical hysterectomy for benign disease, with pelvic pain, urinary frequency, abdominal bloating, and tenderness. Surgical exploration revealed myometrial implants, along with a larger mass on the mesentery of the sigmoid composed of endometrium with complex atypical hyperplasia in a patient without a prior history of complex atypical hyperplasia. The patient was symptom-free 6 months postoperatively.

Conclusion

Histology found during reoperation after laparoscopic supracervical hysterectomy includes endometriosis, residual endometrium, and leiomyomas. In this case, a woman with no prior history of endometrial atypia later developed complex adenomatous endometrial hyperplasia in a peritoneal implant. This finding adds to the list of possible complications after laparoscopic-assisted supracervical hysterectomy and uterine morcellation.

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Condition tags

endometriosis

MeSH descriptors

Endometrial Hyperplasia Endometrial Hyperplasia Endometriosis Endometriosis Hysterectomy Prostheses and Implants Endometrial Hyperplasia Endometrial Hyperplasia Endometriosis Endometriosis Female Humans Hysterectomy Leiomyoma Leiomyoma Middle Aged Prostheses and Implants Treatment Outcome Uterine Neoplasms Uterine Neoplasms

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