Objective: To determine the prevalence of premalignant or malignant (atypical hyperplasia or endometrial cancer) disease that develops in polyps or coexist it and the relationship between the demographic and clinical characteristics of the patients and malignancy by examining the pathology results of patients who underwent hysteroscopy for a preliminary diagnosis of endometrial polyp.
Patients and Methods: We retrospectively evaluated 527 patients whose preliminary diagnoses made by transvaginal ultrasonographic findings or with clinical suspicion and tissue samples taken by hysteroscopy between June 2012 and June 2017. The demographic and clinical data of patients who were reported as pathologic diagnosis of benign endometrial pathologies and premalign (polyp + atypical hyperplasia) or malign (polyp + endometrial cancer) were evaluated.
Results: We detected endometrial polyp in 405 (76.8%) patients, polyp and endometrial hyperplasia without atypia in 51 (9.6%) patients, other benign conditions in 60 (11.3%) patients (leiomyoma uteri, proliferative/secretory/atrophic endometrium), polyp and atypical endometrial hyperplasia in 4 (0.8%) patients and endometrium adenocarcinoma in 7 (1.3%) patients. The incidence of premalignant or malignant disease associated with endometrial polyp was 2.1%.
Conclusions: Endometrial polyps are quite common and are not often considered to be cancerous lesions but rarely associated with cancer, especially with advancing age. The most risky group of patients with endometrial polyps for endometrial cancer who have postmenopausal bleeding consists of those with additional risk factors for this malignancy. The management of endometrial polyp cases should be individualized considering the patient’s age, menopausal status, symptoms and clinical risk factors.
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