Updated: 10/12/2018

Endometrial Polyp

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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
 

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