title: Premalignant and malignant lesions in endometrial polyps in patients undergoing hysteroscopic polypectomy.
abstract: OBJECTIVE
  To evaluate the incidence of premalignant lesions and cancer in endometrial polyps, in patients undergoing hysteroscopic polypectomy.
  
  
  METHODS
  The results of 1,020 pathological examinations of patients submitted to hysteroscopic polypectomy were analyzed, as well as their diagnostic and surgical hysteroscopy findings. As to their menstrual status, 295 (28.9%) patients were in menacme. Of the total, 193 (65.4%) presented abnormal uterine bleeding, and 102 (34.6%) were asymptomatic with altered endometrial echo on transvaginal ultrasound. Out of 725 (71.1%) postmenopausal patients, 171 (23.6%) were symptomatic (abnormal uterine bleeding), and 554 (76.4%) were asymptomatic with endometrial echo >5.0mm.
  
  
  RESULTS
  Twenty-one (2.0%) patients presented premalignant lesions in the polyps, 13 had simple glandular hyperplasia, of which 5 had no atypia, and eight presented atypia. Eight polyps presented focal area of complex hyperplasia: 4 with atypia and 4 without lesions. Cancer was diagnosed in 5 (0.5%) polyps. Of the 21 polyps that harbored premalignant lesions, 12 were interpreted as benign in diagnostic and surgical hysteroscopy. Of the polyps with cancer, 4 were also histeroscopically interpreted as normal.
  
  
  CONCLUSIONS
  Symptomatic polyps in menacme and in all postmenopausal women should be resected and submitted to histopathological examination, since they may have a benign aspect, even when harboring areas of cellular atypia or cancer.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Lenci
authors.affiliation: Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Vanessa Alessandra Lui do
authors.initials: VA
authors.lastname: Nascimento
authors.affiliation: Hospital do Servidor Público Estadual ?Francisco Morato de Oliveira?, São Paulo, SP, Brazil.
authors.forename: Ana Beatriz
authors.initials: AB
authors.lastname: Grandini
authors.affiliation: Hospital do Servidor Público Estadual ?Francisco Morato de Oliveira?, São Paulo, SP, Brazil.
authors.forename: Walid Makin
authors.initials: WM
authors.lastname: Fahmy
authors.affiliation: Hospital do Servidor Público Estadual ?Francisco Morato de Oliveira?, São Paulo, SP, Brazil.
authors.forename: Daniella de Batista
authors.initials: Dde B
authors.lastname: Depes
authors.affiliation: Hospital do Servidor Público Estadual ?Francisco Morato de Oliveira?, São Paulo, SP, Brazil.
authors.forename: Fausto Farah
authors.initials: FF
authors.lastname: Baracat
authors.affiliation: Hospital do Servidor Público Estadual ?Francisco Morato de Oliveira?, São Paulo, SP, Brazil.
authors.forename: Reginaldo Guedes Coelho
authors.initials: RG
authors.lastname: Lopes
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D016889:Endometrial Neoplasms / Q000453:epidemiology*; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000453:epidemiology / Q000473:pathology; D015907:Hysteroscopy / Q000379:methods*; D015994:Incidence; D008875:Middle Aged; D011127:Polyps / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
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