Pathophysiology and management of endometrial hyperplasia and carcinoma. West J Med ; Click here to see the Library ]. Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age
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Open in a separate window This reduction to 2 categories was not only due to the need to do away with the confusing multitude of terms currently in use. Rather, it reflects a new understanding of molecular genetic changes. Hyperplasias without atypia exhibit no relevant genetic changes.
They are benign changes and will regress again after the endocrine milieu physiological gestagen levels has normalized. Atypical endometrial hyperplasias exhibit many of the mutations typical for invasive endometrioid endometrial cancer 7. The implications for treatment are obvious: hyperplasias without atypia should generally be treated conservatively normalization of the cycle through weight loss, metformin; oral contraceptives; cyclical gestagens; gestagen IUD.
Preventive hysterectomy should only be considered in exceptional cases e. The surgery should be done as a total hysterectomy, i. Conservative treatment with high-dose gestagens and close histological monitoring should only be considered in exceptional cases when the patient wants to have children, satisfactory compliance 1 , 4 , 6.
Conclusion The new WHO classification represents an important simplification for clinical practice, particularly with regard to the choice of treatment. Until the new classification comes into general use it would be useful if histological findings include both the new and the previous WHO classification.
Supporting Information German supporting information for this article 68K, pdf References 1. Zuckschwerdt Verlag; Endometrial intraepithelial neoplasia.
Arch Pathol Lab Med. Patients with atypical hyperplasia of the endometrium should be treated in oncological centers. Gynecol Oncol. Management of endometrial precancers. Obstet Gynecol. Tumours of the uterine Corpus: epithelial Tumours and Precursors; pp. Cancer Genome Atlas Research Network. Integrated genomic characterization of endometrial carcinoma.
Overview Endometrial hyperplasia refers to the thickening of the endometrium. This is the layer of cells that line the inside of your uterus. When your endometrium thickens, it can lead to unusual bleeding. Read on for tips on how to recognize symptoms and get an accurate diagnosis. There are two main types of endometrial hyperplasia, depending on whether they involve unusual cells, known as atypia. The two types are: Endometrial hyperplasia without atypia.
Simple endometrial hyperplasia
Open in a separate window This reduction to 2 categories was not only due to the need to do away with the confusing multitude of terms currently in use. Rather, it reflects a new understanding of molecular genetic changes. Hyperplasias without atypia exhibit no relevant genetic changes. They are benign changes and will regress again after the endocrine milieu physiological gestagen levels has normalized.
What Is Endometrial Hyperplasia and How Is It Treated?
Imaging the endometrium: disease and normal variants. Radiographics full text - Pubmed citation 2. Prediction of benign and malignant endometrial disease: hysterosonographic-pathologic correlation. Radiology full text - Pubmed citation 3. Thickened endometrium in the postmenopausal woman: sonographic-pathologic correlation. Radiology abstract - Pubmed citation 4. Endometrial polyps, hyperplasia, and carcinoma in postmenopausal women: differentiation with endovaginal sonography.