Risk of coexisting endometrial carcinoma in case of atypical endometrial hyperplasia diagnosed on total hysteroscopic resection

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• 作者：Audrey Pivano^a ; Patrice Crochet^a ; Xavier Carcopino^b ; Ludovic Cravello^a ; Lé ; on Boubli^b ; Aubert Agostini^a ; ^{aubert.agostini@ap-hm.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Atypical endometrial hyperplasia ; Endometrial carcinoma ; Hysteroscopic resection
• 刊名：European Journal of Obstetrics & Gynecology and Reproductive Biology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：203
• 期：Complete
• 页码：210-213
• 全文大小：252 K

文摘

To evaluate the rate of coexisting endometrial carcinoma or atypical endometrial hyperplasia (AEH) residue in patients who had a total hysteroscopic resection with diagnosis of AEH and without suspicious lesions detected during hysteroscopy.

Study design

This retrospective bicentric study included patients diagnosed with AEH on hysteroscopic resection products, and who subsequently underwent secondary hysterectomy. Cases of hysteroscopic appearance suggesting an endometrial carcinoma were excluded. Histopathological results of hysterectomy specimen determined the persistence or absence of AEH and the possible presence of coexisting endometrial carcinoma.

Results

Thirty-two patients were selected. Histopathological analysis of hysterectomy specimens diagnosed an absence of AEH in 24/32 (75%) subjects, an AEH residue in 6/32 (18.8%) subjects and a coexisting endometrial carcinoma in 2/32 (6.2%) subjects.

Conclusion

The risk of missing an endometrial carcinoma in patients diagnosed with AEH based on total hysterocopic resection is low when there is no suspicious hysteroscopic aspect, but this risk cannot be entirely excluded. Total hysteroscopic resection may be a possible alternative to hysterectomy in patients with AEH who refuse hysterectomy or are a high surgical risk. These patients require a close and long term follow-up due to the risks of residual lesion.