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Updated: Sep 21 2019

Endometrial Hyperplasia

4.6

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Images
https://upload.medbullets.com/topic/116032/images/endometrial hyperplasia.jpg
https://upload.medbullets.com/topic/116032/images/endometrial_hyperplasia_2.jpg
  • Snapshot
    • A 60-year-old G0 female was found on outpatient endometrial biopsy to have abnormal proliferation of stromal and glandular endometrial elements.
  • Overview
  • Introduction
    • An estrogen-dependent hyperplasia affecting mainly postmenopausal women
      • incidence peaks between ages 50 and 60
    • Risk factors include
      • increased estrogen exposure
        • unopposed postmenopausal estrogen replacement
        • obesity
        • nulliparity
        • late menopause (after age 52)
        • polycystic ovarian syndrome
        • estrogen-producing tumors
        • anovulation
      • cancer syndromes
        • hereditary nonpolyposis colon cancer
    • 3 classes of hyperplasia severity
      • simple
        • ↑ number of glands with no crowding
      • complex
        • ↑ number of branching glands with crowding
      • atypical
        • ↑ number of atypical glands with crowding
        • highest risk of progression to endometrial cancer
  • Presentation
    • Symptoms
      • abnormal uterine bleeding
      • post-menopausal bleeding
  • Evaluation
    • Tissue biopsy
      • gold standard
  • Treatment
    • Pharmacologic
      • progesterone
        • indications
          • simple or complex hyperplasia
        • used to reverse hyperplastic process
    • Surgical
      • hysterectomy
        • indications
          • atypical hyperplasia
        • because of high chance of invasion
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