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shell outTo manage a circumscribed tumour by “enucleation”. Shelling out is only warranted in tumours that are known with 100% certainty to be benign—e.g., uterine fibromas—and amenable to complete removal in the first procedure. Shelling out constitutes malpractice for well-circumscribed, nonencapsulated tumours, as fingerlets of proliferating tissue—benign or malignant—may form a nidus for future recurrence and make what would have been an easy, non-shelling excision, extremely difficult due to multiple foci of growth.
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