Transcervical resection of prolapsed giant endometrial polyp with endometrioid adenocarcinoma in a patient with risk factors for malignancy
- Author:
Cortes-Gaspar Tawny Ann P.
;
Oblepias Enrico Gil C.
- Publication Type:Journal Article
- MeSH:
Human;
Female;
Middle Aged;
CARCINOMA, ENDOMETRIOID;
HYSTEROSCOPY;
ENDOMETRIAL NEOPLASMS
- From:
Philippine Journal of Reproductive Endocrinology and Infertility
2012;9(1):15-22
- CountryPhilippines
- Language:English
-
Abstract:
A premenopausal woman witj multiple risk factors for endometrial cancer, diagnosed with giant endometrial polyp with benign features on preoperative biopsy is presented. On hysteroscopy, intraoperative frozen section revealed a benign polyp, but was malignant on final histopathology. Definitive surgery yielded simple hyperplasia and endometrial polyp. Giant endometrial polyp grows to 9-12cm diameter. Complications in hysterosocopic removal of giant polyps are higher risk of perforation, more blood loss, hyponatremia, pulmonary edema, and hyperglycemia. All associated with dificult visualization and prolonged surgery. Frozen section of endometrial mass may help in instituting appropriate treatment. Local studies show high accuracy, although some reports were conflicting. In case of malignancy, maintenace of intrauterine pressure distention to less than 70mm Hg prevents dissemination of cancer cells. The hyperestogenic state seen in obesity with uncontrolled hypertension, diabetes, nulliparity and vaginal bleeding were associated in developing endometrial cancer arising from endometrial polyp resected by hysteroscopy.
