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Uterine sarcomas are rare, but benign leiomyomas (fibroids) are extremely common and frequently require surgery: either hysterectomy or myomectomy. A rare but potentially devastating consequence of myomectomy is inadvertent incomplete resection of a uterine sarcoma, resulting in tumor dissemination and a worse prognosis. The authors discuss the acceptable level of risk and how such a risk could be mitigated.