Malignant and premalignant changes in the endometrium of women with an ultrasound diagnosis of endometrial polyp

Gambadauro, Pietro; Martínez-Maestre, María Ángeles; Schneider, J; Torrejón, Rafael

doi:10.3109/01443615.2014.916255

Cited by 13 publications

(13 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In multivariable analyses no significant association between (pre‐)malignant changes in a polyp and older age, postmenopausal status, tamoxifen use or bleeding at presentation could be found. Of all polyps in this study, only 2.7% showed atypical hyperplasia and 1.1% showed endometrial carcinoma, which is in line with literature 9,16–19 …”

Section: Discussionsupporting

confidence: 92%

Atypical endometrial polyps and the incidence of endometrial cancer: a retrospective cohort study

Jacobs

Tibosch

Geomini

et al. 2020

BJOG

View full text Add to dashboard Cite

Objective The aim of this study was to evaluate the incidence of endometrial carcinoma, proven after hysterectomy, in patients diagnosed with atypical endometrial hyperplasia confined to a polyp. A secondary aim was to establish factors associated with (pre‐)malignant alterations in a polyp. Design A retrospective cohort study. Setting Maastricht University Medical Centre (MUMC+) and Máxima Medical Centre in Eindhoven/Veldhoven (Máxima MC). Population Women who underwent a hysteroscopic polyp resection between 2008 and 2016. Methods Patient characteristics and histopathology results of the polyp and, in the case of a hysterectomy, uterus were collected from patients’ charts. Results A total of 1445 complete hysteroscopic polyp resections were included. Of those, 1390 polyps showed benign histopathology results, 39 polyps contained atypical hyperplasia and 16 polyps contained endometrial carcinoma. A hysterectomy was performed in 35 women who were diagnosed with atypical hyperplasia confined to a polyp after hysteroscopic polyp resection. Histopathological assessment showed no additional (pre‐)malignant changes of the endometrium in 12 women (30.8%), atypical hyperplasia in 11 women (28.2%) and endometrial carcinoma in 12 women (30.8%). None of the prognostic factors under consideration were significantly associated with (pre‐)malignant changes in a polyp. Conclusion The incidence of endometrial carcinoma in the surrounding endometrium after complete resection of a polyp with atypical hyperplasia is 30.8% in this study. This supports the current advice to perform a hysterectomy and bilateral salpingo‐oophorectomy. No prognostic factor for (pre‐)malignant changes in a polyp was established. Tweetable abstract The incidence of endometrial carcinoma after complete resection of a polyp with atypical hyperplasia is high.

show abstract

Section: Discussionsupporting

confidence: 92%

Atypical endometrial polyps and the incidence of endometrial cancer: a retrospective cohort study

Jacobs

Tibosch

Geomini

et al. 2020

BJOG

View full text Add to dashboard Cite

show abstract

“…Polyps are an increasingly common finding [3, 10]; however, their association with malignancy is controversial in younger and asymptomatic women [11]. In our case, in spite of hysteroscopic resection and oral progestins treatment, the initially diagnosed atypia turned out to be an endometrial cancer at final diagnosis, which is a known possibility [12]. The cancer was also still present on the final specimen, meaning that it was not confined to the resected polypoid area, as often reported in the literature [12].…”

Section: Discussionmentioning

confidence: 83%

“…In our case, in spite of hysteroscopic resection and oral progestins treatment, the initially diagnosed atypia turned out to be an endometrial cancer at final diagnosis, which is a known possibility [12]. The cancer was also still present on the final specimen, meaning that it was not confined to the resected polypoid area, as often reported in the literature [12]. It seems therefore worth reminding that, although conservative treatment of early stage endometrial cancer by means of progestins and hysteroscopic resection has been proposed [9, 13], the gold standard includes a total hysterectomy [14].…”

Section: Discussionmentioning

confidence: 99%

Endometrial cancer in a woman undergoing hysteroscopy for recurrent IVF failure

Gambadauro

Gudmundsson

2017

Gynecol Surg

View full text Add to dashboard Cite

BackgroundHysteroscopy, despite being the undisputed gold standard for the examination of the uterine cavity, is controversial as a routine procedure in infertile women. However, benign intrauterine conditions are common in women suffering repeated in vitro fertilization (IVF) failure, and growing evidence suggests a unique diagnostic and therapeutic role for hysteroscopy. Endometrial malignancy, on the contrary, is unreported by large published series of women with repeated IVF failures undergoing hysteroscopy, and its impact on fertility, for obvious reasons, has not been studied.ResultsAn unsuspected endometrial cancer was diagnosed in an asymptomatic 38-year-old woman undergoing hysteroscopy because of several repeated failures of in vitro fertilization and embryo transfer.ConclusionsEndometrial cancer can be found at hysteroscopy in young women with repeated IVF failures. The possibility of repeatedly unsuccessful fertility treatments should be taken into account when counseling infertile women about conservative treatment of endometrial cancer.

show abstract

“…5 Few studies have described the aggressiveness of a tumor that is associated with polyps. 1,6 In the case of EC in a polyp, the thickness of the parenchyma of the polyp can be a protective factor against myometrial invasion, based on reports of the absence of residual disease after polypectomy in patients with EC. 1,2 Atypical hyperplasia in a polyp usually requires a more conservative treatment.…”

Section: Introductionmentioning

confidence: 99%

Residual Disease after Operative Hysteroscopy in Patients with Endometrioid Endometrial Cancer Associated with Polyps

Simonsen

Mantoan

Faloppa

et al. 2021

Rev Bras Ginecol Obstet

View full text Add to dashboard Cite

Objective To evaluate the presence of residual disease in the uterine specimen after hysteroscopic polypectomy or polyp biopsy in patients with endometrioid endometrial cancer (EC). Methods We analyzed a series of 104 patients (92 cases from the Hospital AC Camargo and 12 from the Hospital do Servidor Público Estadual de São Paulo) with polyps that were diagnosed by hysteroscopy, showing endometrioid EC associated with the polyp or in the final pathological specimen. Patients underwent a surgical approach for endometrial cancer from January 2002 to January 2017. Their clinical and pathological data were retrospectively retrieved from the medical records. Results In 78 cases (75%), the polyp had EC, and in 40 (38.5%), it was restricted to the polyp, without endometrial involvement. The pathologic stage was IA in 96 cases (92.3%) and 90 (86.5%) had histologic grade 1 or 2. In 18 cases (17.3%), there was no residual disease in the final uterine specimen, but only in 9 of them the hysteroscopy suggested that the tumor was restricted to the polyp. In 5 cases (4.8%) from the group without disease outside of the polyp during hysteroscopy, myometrial invasion was noted in the final uterine specimen. This finding suggests the possibility of disease extrapolation through the base of the polyp. Conclusion Patients with endometrioid EC associated with polyps may have the tumor completely removed during hysteroscopy, but the variables shown in the present study could not safely predict which patient would have no residual disease.

show abstract

Malignant and premalignant changes in the endometrium of women with an ultrasound diagnosis of endometrial polyp

Cited by 13 publications

References 22 publications

Atypical endometrial polyps and the incidence of endometrial cancer: a retrospective cohort study

Atypical endometrial polyps and the incidence of endometrial cancer: a retrospective cohort study

Endometrial cancer in a woman undergoing hysteroscopy for recurrent IVF failure

Residual Disease after Operative Hysteroscopy in Patients with Endometrioid Endometrial Cancer Associated with Polyps

Contact Info

Product

Resources

About