Endometrial carcinoma in asymptomatic postmenopausal women with a thickened endometrium

Abstract

Introduction. The most common clinical manifestation of endometrial cancer is postmenopausal bleeding, as well as irregular uterine bleeding. Far less often, endometrial cancer may also be present in postmenopausal women without bleeding. The aim of our study was to examine the incidence of endometrial cancer in asymptomatic postmenopausal women with a thickened endometrium. Material and Methods. The research included 251 asymptomatic postmenopausal women with endometrial thickness over 4 mm established by ultrasound. Exploratory curettage was performed in all the patients, followed by histopathological examination of the obtained material. Results. The average age of the respondents was 65.38 ? 26.69 years. The average thickness of the endometrium was 15.68 ? 5.06 mm. Of all the patients, 70.13% presented with benign endometrial disease; endometrial polyps were found in 58.18% and simplex hyperplasia of the endometrium without atypia in 11.95%. Endometrial cancer was found in 1.59% of patients, ovarian cancer metastasis in 0.4%, and endometrial hyperplasia with atypia in 1.59% of patients. All cases of endometrial cancer were diagnosed in patients with endometrial thickness over 11 mm. Conclusion. The approach to asymptomatic women with endometrial hyperplasia should be individual. Exploratory curettage/hysteroscopy should be recommended to patients with endometrial thickness over 11 mm in order to detect and evaluate for endometrial cancer. Asymptomatic women with endometrial thickness of 4 - 10 mm should be further examined, especially in case of associated risk factors or other ultrasound parameters that indicate more serious endometrial pathology.