Snapshot A 35-year-old woman presents to her gynecologist for irregular periods and frequent spotting. She has been trying to get pregnant for 1.5 years now and realized that having irregular periods may mean something is wrong. She has never been pregnant before. She denies any history of STIs. She undergoes a transvaginal ultrasound, which reveals several small masses in the uterine cavity. Overview Introduction Benign collection of endometrial tissue in the uterine wall that extend into the uterine cavity Also known as uterine polyps Ranges from a few millimeters to several centimeters in diameter Pathogenesis grow in response to estrogen Epidemiology in women going through or have completed menopause Risk factors hypertension obesity tamoxifen Presentation Symptoms irregular menstrual bleeding bleeding between periods excessively heavy periods bleeding after menopause spotting Evaluation Transvaginal ultrasound Hysteroscopy Endometrial biopsy to confirm most uterine polyps are benign however, endometrial hyperplasia or carcinomas may appear as polyps Differential Diagnosis Uterine fibroids Endometrial carcinoma Endometrial hyperplasia Treatment If not suspicious for cancer, observation with good follow-up Surgical removal curettage Prognosis, Prevention, and Complications Prognosis typically very good 0.5% of polyps contain malignant cells Complications infertility