Unexpected malignant uterine pathology: Incidence, characteristics and outcome in a large single-center series of hysterectomies for presumed benign uterine disease.

•Unexpected uterine malignancies after hysterectomy were rare with an incidence of 44/10.765 (0.42%).•Most unexpected uterine malignancies were endometrial carcinomas (0.31%), with only few uterine sarcomas (0.11%).•Outcome of patients with unexpected uterine malignancies is favorable, particularly for unexpected endometrial carcinomas.•So far no patient treated with intraoperative power morcellation has had an locoregional relapse.•Thorough preoperative workup and expert pathology are important for optimal patient treatment.