Predicting Atypia Inside Endometrial Polyps

Pérez-Medina, Tirso; Bajo, J.M.; Huertas, Miguel A.; Rubio, Ángel

doi:10.7863/jum.2002.21.2.125

Cited by 39 publications

(20 citation statements)

References 13 publications

(15 reference statements)

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“…Some authors suggested that evaluation of tissue vascularization by color Doppler imaging may be useful in predicting malignant endometrial changes, as malignancy is associated with increased blood flow [14,15] . Similarly, low blood flow resistance is reported to be predictive of atypical endometrial polyps [16] . It has been suggested that the quality and accuracy of the Doppler examination can be improved by enhancement with intravenous contrast combined with color Doppler imaging [17] .…”

Section: Discussionmentioning

confidence: 99%

Endometrial Polyps: Symptomatology, Menopausal Status and Malignancy

Golan¹,

Cohen-Sahar²,

Keidar³

et al. 2010

Gynecol Obstet Invest

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Aims: To assess the frequency of premalignant and malignant endometrial polyps in symptomatic and asymptomatic women. Methods: Retrospective registration of 1,124 patients who underwent hysteroscopic resection of endometrial polyps. Patient characteristics included age, menopausal status, presence or absence of symptoms, and use of hormonal medication. Histological diagnoses and complications were also analyzed. Results: 641 (57%) of 1,124 women with endometrial polyps were postmenopausal and 483 (43%) premenopausal. Abnormal uterine bleeding was reported by 548 women: 226 (49%) postmenopausal and 322 (51%) premenopausal. 576 (51%) women were asymptomatic. There were 16 patients with malignancy or premalignant conditions among the symptomatic patients (2.7%) compared to 7 such patients among the asymptomatic patients (1.3%; p = 0.17). Pathologic evaluation disclosed 7 cases of malignancy and 4 cases of atypical hyperplasia among bleeding postmenopausal women (11/263, 4%) and 2 malignancies and 3 cases of hyperplasia with atypia among asymptomatic postmenopausal women (5/378, 1.3%). Conclusion: We found premalignancy and malignancy in each patient group – pre- and postmenopausal, as well as symptomatic and asymptomatic. We recommend removal of any verified endometrial polyp.

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Section: Discussionmentioning

confidence: 99%

Endometrial Polyps: Symptomatology, Menopausal Status and Malignancy

Golan¹,

Cohen-Sahar²,

Keidar³

et al. 2010

Gynecol Obstet Invest

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“…In addition, low rates of resistance have been related to the degree of atypia and were found to be highly predictive [13]. Another study could not identify any distinct hysteroscopic feature of malignancy, but all malignant polyps removed by operative hysteroscopic were symptomatic [14].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of endometrial-polyp treatment with hysteroscopy in operating room

et al. 2007

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To assess the results of using a resectoscope in the hysteroscopic resection of endometrial polyps that were previously diagnosed by office hysteroscopy and to demonstrate the necessity of extraction for histological study. A prospective long-term follow-up study (level of evidence II-2). University Hospital. 303 women presenting a hysteroscopic image of an endometrial polyp. Interventions: Office hysteroscopy, hysteroscopic resection of polyps by means of a resectoscope and an anatomopathological study of the polyps. Statistical analysis was performed. 303 diagnosed endometrial polyp formations were resected by means of hysteroscopy during surgery. In all cases, biopsies of the uterine cavity or of the polyp were negative. Resection of the polyps with hysteroscopy in the operating room using a resectoscope proved to be a safe technique. The anatomopathological study of the polyps showed hyperplasia with atypias in 10 cases (3.3%) and endometrial cancer in 9 women (3.0%). Our study data suggest that endometrial polyps should be resected because they may harbor malignant or premalignant lesions. Hysteroscopic surgery is recommended for its simplicity and scant complications.

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“…El amplio intervalo esta dado por diferencias en definición, método diagnóstico y población estudiada (17). Gracias a la ultrasonografía de alta definición, la hidrosonografía y la histeroscopia, su frecuencia diagnóstica ha aumentado ostensiblemente (30)(31)(32). Es así como en pacientes con sangrado uterino anormal su prevalencia llega a un 10-40% ( 6,27,33,34), no superando el 12% en grupos asintomáticos estudiados por otras causas (18,35).…”

Section: Clínica Y Epidemiologíaunclassified

“…Otras terapias médicas como los análogos GnRH que causan menopausia artificial, no cuentan con suficiente evidencia para ser recomendado como tratamiento único, y su mayor utilidad está en el manejo preresección histeroscópica, en casos de pólipos de gran volumen, para reducir su tamaño y así permitir un procedimiento técnicamente más simple (35,56).…”

Section: Tratamientounclassified

Pólipos endometriales: Actualización en diagnóstico y tratamiento

2016

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: Los pólipos endometriales son protrusiones nodulares benignas de la superficie endometrial con características clínico-patológicas propias y de origen desconocido. Su prevalencia es alta, especialmente en pacientes con sangrado uterino anormal, se asocia a infertilidad y a cáncer de endometrio, lo que se traduce en que se trata de una patología muy importante en el quehacer ginecológico habitual. Objetivos: Revisar la patogenia, actualizar y evaluar los métodos diagnósticos, y definir las mejores opciones terapéuticas de esta frecuente patología. Método: Revisión sistemática de la literatura publicada en el tema, mediante búsqueda en base de datos Pub Med. Resultados: La patogenia es aun desconocida, es una patología muy heterogénea y no hay causa única, se han reportado varios hallazgos relacionados con alteraciones genéticas. La ultrasonografía de alta definición, la hidrosonografia y la histeroscopia son el estándar actual en el diagnóstico. Las opciones terapéuticas se extienden desde la observación y seguimiento con imágenes, hasta la histerectomía con biopsia contemporánea, siendo la histeroscopia quirúrgica el método más costo efectivo. Conclusión: La patogenia de los pólipos endometriales se encuentra actualmente en revisión, no hay ninguna teoría que explique la génesis de todos los pólipos. La ultrasonografía con contraste y la histeroscopia constituyen el estándar en el diagnóstico. En el tratamiento, la indicación es la cirugía histeroscopica y en especial la resección electroquirúrgica, que permite una extracción completa del pólipo bajo visión directa, con enfoque diagnóstico y terapéutico, con riesgos bajos y recurrencia mínima. PALABRAS CLAVE: Pólipo endometrial, histeroscopia, resectoscopia SUMMARYBackground: Endometrial polyps are benign nodular protrusions of the endometrial surface with clinical and pathological features of unknown origin. Its prevalence is high, especially in patients with abnormal uterine bleeding, it is associated with infertility and endometrial cancer, what constitutes a common and important disease. Aims: To review the pathogenesis, to update and evaluate diagnostic methods, and to define the best treatment options for this common condition. Methods: A systematic review of the published literature on the subject by searching PubMed database. Results: The pathogenesis is still unknown, it is a very heterogeneous disease and there is no single cause, there have been several findings related to genetic alterations. High definition ultrasonography, the hidrosonography and hysteroscopy are the current standard in diagnosis. Therapeutic options range from observation and follow up with images to the hysterectomy using contemporary biopsy, surgical hysteroscopy being the most cost effective method. Conclusion: The pathogenesis of endometrial polyps are currently under review, there is no theory to explain the genesis of all polyps. Contrast ultrasonography and hysteroscopy are standard in the diagnosis. In the treatment, the

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Predicting Atypia Inside Endometrial Polyps

Cited by 39 publications

References 13 publications

Endometrial Polyps: Symptomatology, Menopausal Status and Malignancy

Endometrial Polyps: Symptomatology, Menopausal Status and Malignancy

Outcomes of endometrial-polyp treatment with hysteroscopy in operating room

Pólipos endometriales: Actualización en diagnóstico y tratamiento

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