Premalignant and malignant changes in endometrial polyps

Abstract

The objective of this study was to evaluate the risk of premalignant and malignant changes in endometrial polyps that were removed entirely by operative hysteroscopy. The study group was comprised of 101 cases of endometrial polyps diagnosed by diagnostic hysteroscopy, transvaginal ultrasonography and saline contrast sonohysterography in our Obstetrics and Gynecology Clinic from January 2010 to July 2012. A retrospective chart review was then performed with the use of medical records. The operative procedure was performed under general anesthesia. The specimens were placed in 10% formaldehyde for histological examination. Clinical characteristics such as age, parity, menopausal status, hypertension (defined as diastolic pressure ≥90 mm Hg and/or systolic pressure ≥140 mm Hg), abnormal uterine bleeding, diabetes (fasting glucose ≥110 mg/dl) were also reported from the medical records. Statistical Analysis was performed by using the SPSS 11.5 statistical software package (SPSS, Chicago, IL, USA). The mean age of the study group was 45 (25-73) years-old. The most common indication for performing operative hysteroscopy was abnormal uterine bleeding 82.2% (n=83). It is worthwhile to note that 3 patients (2.9%) had premalignant and malignant changes of polyps. One patient who was 58 years old had invasive endometrial cancer. None of the clinical variables considered (diabetes mellitus, hypertension, hormone replacement therapy) were statistically related to the histopathological results. Although the prevalence of premalignant and malignant endometrial polyps is very low, the early diagnosis of malignancy is very important. The most common indication was abnormal uterin bleeding for performing operative hysterescopy.