title: Endometrial Cancer: Hidden Pathology in a Patient with Abnormal Uterine Bleeding and Known Leiomyoma.
abstract: Uterine leiomyomas and endometrial pathology are both associated with abnormal uterine bleeding. We report a case in which a nulliparous woman with heavy uterine bleeding and leiomyomas had undergone two prior hysteroscopic myomectomies for benign leiomyomas. She was evaluated, but was ineligible for a clinical trial of a novel Magnetic Resonance guided High Intensity Focused Ultrasound (MRgx200B;HIFU) device. The 8 cm, prolapsed submucosal leiomyoma hindered endometrial sampling and was inaccessible to HIFU treatment. Preoperatively, neither endometrial sampling nor saline sonohysterography was technically feasible. She underwent hysterectomy, and on histological examination of specimen, stage 1A grade 1 endometrial carcinoma was found on the endometrial side of the prolapsing fibroid. Endometrial pathology is an important consideration in the evaluation of abnormal uterine bleeding, even in women with large prolapsing leiomyoma.
authors: Epsom and St. Helier NHS Trust, Surrey, UK.
authors: Trisha
authors: T
authors: Sri
authors: Albert J
authors: AJ
authors: Steren
authors: Pamela
authors: P
authors: Stratton
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery; D014592:Uterine Hemorrhage / Q000473:pathology*; D063186:Uterine Myomectomy
references: Obstet Gynecol. 2008 Feb;111(2 Pt 1):436-47
references: 18238985
references: Obstet Gynecol. 2009 Sep;114(3):523-9
references: 19701030
references: Obstet Gynecol. 2010 Jul;116(1):168-76
references: 20567184
references: Obstet Gynecol. 2011 Feb;117(2 Pt 1):396-403
references: 21252757
references: Gynecol Oncol. 2011 Dec;123(3):537-41
references: 21925719
references: Best Pract Res Clin Obstet Gynaecol. 2012 Jun;26(3):311-24
references: 22277287
references: J Vasc Interv Radiol. 2012 Jun;23(6):786-794.e4
references: 22626269