title: Endometrial cancer in patients with preoperative diagnosis of atypical endometrial hyperplasia.
abstract: OBJECTIVE
  Atypical endometrial hyperplasia (AEH) has been associated with the presence of concomitant endometrial carcinoma (EC). The aim of this study is to examine the frequency of coexisting endometrial carcinoma when atypical endometrium hyperplasia was found upon biopsy. We also evaluated the influence of preoperative diagnostic techniques (pipelle and dilation and curettage (D&C)), and the value of transvaginal ultrasound in detecting unexpected tumor invasion.
  
  
  METHODS
  Between January 1992 and December 2003, at the Department of Obstetrics and Gynecology, University of Parma, and Policlinico S. Matteo, Pavia, 70 consecutive patients subjected to total hysterectomy with a histological diagnosis of AEH were retrospectively selected. 52/70 patients underwent vaginal hysterectomy, with bilateral salpingo-oophorectomy (BSO) whereas 18/70 had abdominal hysterectomy with BSO within 8 weeks since the diagnosis of AEH.
  
  
  RESULTS
  We found in 30 of the 70 patients with atypical endometrial hyperplasia in the biopsy coexisting endometrial carcinoma (43%). No differences in diagnostic accuracy between the pipelle method and D&C were found.
  
  
  CONCLUSIONS
  Transvaginal ultrasound was not a feasible method for predicting EC. After a follow-up of an average of 5 years there was, neither in the abdominal operated patients nor in the vaginal operated patients, a recurrence of disease.
authors.affiliation: Maternal and Infant Care Department, University of Parma, Via Gramsci 14, Parma, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Merisio
authors.forename: Roberto
authors.initials: R
authors.lastname: Berretta
authors.forename: Andrea
authors.initials: A
authors.lastname: De Ioris
authors.forename: D Caterina
authors.initials: DC
authors.lastname: Pultrone
authors.forename: Martino
authors.initials: M
authors.lastname: Rolla
authors.forename: Giovanna
authors.initials: G
authors.lastname: Giordano
authors.forename: Saverio
authors.initials: S
authors.lastname: Tateo
authors.forename: Mauro
authors.initials: M
authors.lastname: Melpignano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D004107:Dilatation and Curettage / Q000379:methods; D004714:Endometrial Hyperplasia / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016889:Endometrial Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014463:Ultrasonography