title: Atypical endometrial lesions: hysteroscopic resection as an alternative to hysterectomy.
abstract: BACKGROUND
  Endometrial hyperplasia is a precursor to endometrial carcinoma: the risk of progression to invasive endometrial cancer is increased in postmenopausal women and much more in cases of atypical endometrial hyperplasia (25%-30%). In addition, in 12.7% to 42.6% of cases according to various studies, endometrial cancer coexists in patients with diagnosis of atypical endometrial hyperplasia. The aim of this study was to evaluate the correlation between radical hysteroscopic resection of atypical endometrial lesions and the histopathological examination of the uterus.
  
  
  METHODS
  The authors collected 25 patients referring to the Department of Woman and Child Health, in the University of Padua (Italy) from January 2008 to June 2012, undergoing hysteroscopic resection for atypical polyps and focal atypical endometrial hyperplasia, and following hysterectomy within 30 days. Average age, menopausal status, hormone replacement therapy, body mass index (BMI), presence of hypertension and diabetes, and taking tamoxifen were reported.
  
  
  RESULTS
  After hysteroscopic resection in all patients atypical polyps and focal endometrial hyperplasia were confirmed. The hystopathologic evaluation of the uterus reported: in only two (8%) cases, the persistence of atypical endometrial lesion, whereas in 23 (92%) cases the endometrial tissue was negative for atypia or malignancy.
  
  
  CONCLUSIONS
  Radical endometrial resection by hysteroscopy may serve as an alternative to hysterectomy in selected patients with atypical focal endometrial lesions, not only in fertile women, but also in patients who refuse hysterectomy or present high anesthesiologic and surgical risks, regardless of the risk of recurrence, and with the necessity of undergoing hysteroscopic close follow-up.
authors.affiliation: Department of Health of the Woman and Child, Obstetrics and Gynecology Clinic, University of Padua, Italy. pietro.litta@unipd.it
authors.forename: P
authors.initials: P
authors.lastname: Litta
authors.forename: C
authors.initials: C
authors.lastname: Bartolucci
authors.forename: C
authors.initials: C
authors.lastname: Saccardi
authors.forename: A
authors.initials: A
authors.lastname: Codroma
authors.forename: A
authors.initials: A
authors.lastname: Fabris
authors.forename: S
authors.initials: S
authors.lastname: Borgato
authors.forename: L
authors.initials: L
authors.lastname: Conte
mesh_terms: D000328:Adult; D000368:Aged; D004714:Endometrial Hyperplasia / Q000473:pathology / Q000601:surgery*; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies