Examination of tumor samples obtained after laparoscopic supracervical hysterectomy and a derivative leiomyosarcoma

Unexpected malignant tumors are a rare finding after surgery for symptomatic leiomyomas but there is little doubt that morcellation of these lesions is associated with a higher risk of iatrogenic peritoneal spread compared to women having surgery without morcellation. Thus, the FDA has issued a warning against the use of power morcellation in the majority of women undergoing myomectomy or hysterectomy for treatment of fibroids.We pressent a case report of 50year old patient with intervertebral disc degeneration and multiple uterine fibroids decided to have laparoscopic supracervical hysterectomy. 28 months later the patient cystic adnexal massas removed by laparotomy and histologically, classified as leiomyosarcoma. 19 months after this latter surgery MRI revealed a 10 x 8 x 6 cm abdominal mass attached to the liver and numerous other nodules attached to the abdominal wall. We investigated genomic and expression profiles of four samples obtained from initial surgery and the malignant tumor that appeared 16 month later by molecular inversion probe (MIP) and transcriptome array hybridization. DNA was extracted from FFPE Tissue Samples using Covaris adaptive focused acoutics (AFATM) and truXTRACTM FFPE DNA kit and subjected to array analysis using the Affymetrix OncoScan and human Clariom D platforms according to the manufacturers protocol. Four morcellated specimens of a 50 year old patient with multiple uterine fibroids and a leiomyosarcoma removed 28 later were investigated by molecular inversion probe (MIP) array and transcriptome array analysis. The aim of the study was to investigate if the leiomyosarcoma had developed from one of the leiomyomas as a result of secondary genetic alterations and to compare the expression profiles of the tumors.