A 45-year-old woman with symptomatic fibroids is scheduled for laparoscopic hysterectomy. The surgeon plans to use power morcellation. The FDA black box warning regarding power morcellation is primarily concerned with which risk?
- A Dissemination of occult uterine leiomyosarcoma ✓
- B Bowel injury during tissue extraction
- C Port-site metastasis of endometrial cancer
- D Ureteric injury during morcellation
Correct answer: A. Dissemination of occult uterine leiomyosarcoma
Explanation
The FDA issued a black box warning in 2014 against power morcellation due to risk of disseminating occult uterine sarcoma (leiomyosarcoma), which occurs in approximately 1 in 350 to 1 in 500 women undergoing hysterectomy for presumed fibroids. Dissemination upstages the cancer and worsens prognosis. Contained morcellation in a bag is now recommended when morcellation is unavoidable.
Reference: Te Linde's Operative Gynecology, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.