CARCINOMA IN A POSTMENOPAUSAL ENDOMETRIAL POLYP

Abstract

Introduction:Endometrial polyp is a common pathology found in gynaecological practice.The incidence of
premalignant and malignant findings in endometrial polyps range from 0.5 to 4.8% in the general population and 2 to
10% in postmenopausal women.
case report: A 55yr old P2L2 postmenopausal women came with complaint of vaginal bleeding on and off for 3 months.
On Per vaginal examination uterus retroverted, parous size, fornices free. Ultrasound revealed well defined hypoechoic
lesion of 16.8×14.4 mm in the fundal region of the endometrial cavity Fractional curretage done showed cystic dilatation
of endometrial glands and chronic nonspecific cervicitis. Non descent vaginal hysterectomy + B/L salpingooophorectomy
was done and sent for HPE. Gross examination showed endometrial cavity with a small polyp of 1×0.5cm.
Microscopy showed non secretory cystic dilatation of endometrial glands with no evidence of hyperplasia/malignancy
but the polyp showed features suggestive of a well differentiated endometroid carcinoma villoglandular variant (Grade
1).
Villoglandular carcinoma is characterized by papillary architecture with delicate fibro vascular stalks. Discussion: It is
lined by cuboidal or columnar cells with minimal cellular stratification and mild nuclear pleomorphism . It only invades
the superficial layers of the myometrium, and is usually diagnosed at an early stage. Thus it has a better prognosis than
typical endometrioid carcinoma.
Conclusion: Large symptomatic endometrial polyps, especially those which develop in post menopausal women, have a
tendency to show malignant changes. Careful histological examination of endometrial biopsy to find premalignant and
malignant lesions should be emphasized