Concurrent endometrial carcinoma following hysterectomy for atypical endometrial hyperplasia

Abstract Objective To evaluate the prevalence of concurrent endometrial carcinoma in women diagnosed with atypical endometrial hyperplasia (AEH) by endometrial biopsy. Study design We retrospectively analyzed the medical records of 126 patients who underwent hysterectomies for AEH diagnosed by endom...

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Bibliographic Details
Published in:European journal of obstetrics & gynecology and reproductive biology 2010-05, Vol.150 (1), p.80-83
Main Authors: Hahn, Ho-Suap, Chun, Yi-Kyeong, Kwon, Yong-Il, Kim, Tae-Jin, Lee, Ki-Heon, Shim, Jae-Uk, Mok, Jung-Eun, Lim, Kyung-Taek
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Biopsy
Endometrial biopsy
Endometrial carcinoma
Endometrial hyperplasia
Endometrial Hyperplasia - complications
Endometrial Hyperplasia - diagnosis
Endometrial Hyperplasia - pathology
Endometrial Hyperplasia - surgery
Endometrial Neoplasms - diagnosis
Endometrial Neoplasms - epidemiology
Endometrial Neoplasms - pathology
Endometriosis - complications
Endometrium - pathology
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Humans
Hysterectomy
Korea - epidemiology
Medical sciences
Middle Aged
Obstetrics and Gynecology
Prevalence
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the genital tract and mammary gland
Tumors
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Summary:Abstract Objective To evaluate the prevalence of concurrent endometrial carcinoma in women diagnosed with atypical endometrial hyperplasia (AEH) by endometrial biopsy. Study design We retrospectively analyzed the medical records of 126 patients who underwent hysterectomies for AEH diagnosed by endometrial biopsy from 1999 to 2008. AEH was initially diagnosed by dilatation and curettage (98 cases) or endometrial biopsy with a Z-sampler (24 cases). The remaining four cases were diagnosed by hysteroscopic polypectomy. The results of the endometrial biopsies were graded on an ordinal scale and were compared with pathologic features obtained at the hysterectomy. Results In patients preoperatively diagnosed with AEH by biopsy, hysterectomy specimens revealed a rate of simple or complex endometrial hyperplasia without atypia of 27% with AEH and normal proliferative phases found in 54.7 and 7.9% of specimens, respectively. The incidence of endometrial carcinoma was considerably high (13/126, 10.3%). Eleven of 13 cases were confined to the endometrium and the remaining two were located at the adenomyosis without myometrial invasion. All patients with endometrial carcinoma displayed coexisting atypical complex hyperplasia following hysterectomy. Conclusions Biopsy specimens showing AEH, particularly atypical complex hyperplasia, are associated with a risk of coexisting endometrial carcinoma. When considering management strategies for women with a biopsy diagnosis of AEH, clinicians should take into account the considerable rate of concurrent endometrial cancer and the discrepancy with pathologic diagnosis. Treatment modalities may differ depending on population as the rates of concurrent endometrial cancer with AEH and myometrial invasion vary by geographical location.
ISSN:0301-2115
1872-7654
DOI:10.1016/j.ejogrb.2010.02.002