The malignant potential of endometrial polyps.
OBJECTIVE
To determine the pre-malignant and malignant potential of endometrial polyps and to assess whether different clinical parameters are associated with malignancy in the polyps.


METHODS
Four hundred and thirty consecutive cases of hysteroscopic diagnosis of endometrial polyp were retrieved. The medical records, preoperative vaginal sonography results and histopathology findings were reviewed. Statistical analysis was performed.


RESULTS
Hysteroscopy truly identified endometrial polyps in 95.7% of the cases. In 11.4% cases, hyperplasia without atypia was found in the endometrial polyp. In 3.3 and 3.0% of women pre-malignant or malignant conditions were found in the polyp. Older age, menopause status and polyps larger than 1.5 cm were associated with significant pre-malignant or malignant changes, although the positive predictive value for malignancy was low. All the malignant polyps were diagnosed only in postmenopausal women. The presence of postmenopausal or irregular vaginal bleeding, was not a predictor of malignancy in the polyp.


CONCLUSIONS
Postmenopausal women with endometrial polyps are at increased risk of malignancy in the polyp. Those patients, whether symptomatic or not should be evaluated by hysteroscopic resection of the polyps. Asymptomatic premenopausal patients with polyps smaller than 1.5 cm can be observed.
Ben-Arie
Alon
A
Department of Obstetrics and Gynecology, Kaplan Medical Center, PO Box 1, Rehovot 76100, Israel. abenarie@hotmail.com
Goldchmit
Chen
C
Laviv
Yosef
Y
Levy
Roni
R
Caspi
Benjamin
B
Huszar
Monica
M
Dgani
Ram
R
Hagay
Zion
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis*; D017698:Postmenopause; D011230:Precancerous Conditions / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors