title: The Use of Transvaginal Ultrasound in Type II Endometrial Cancer.
abstract: OBJECTIVE
  To determine the use of the transvaginal ultrasound (TVUS) in postmenopausal women with type II endometrial cancer.
  
  
  METHODS
  A retrospective review was conducted for 173 women with pathology proven type II endometrial cancer at a single institution. Those who underwent preoperative TVUS were included, and the following data were obtained: endometrial stripe (EMS) measurement, uterine and/or adnexal findings, and uterine size/volume. Clinicopathologic factors were abstracted. Descriptive and regression analyses were performed.
  
  
  RESULTS
  Fifty-eight women comprised the cohort, and the median age was 66.5 years (50-85 years). The most commonly reported symptom was postmenopausal bleeding in 53 patients (91.4%). The EMS was reported as thin (≤ 5 mm) or indistinct in 16 patients (27.5%). Approximately 60% of patients had 1 or more ultrasound abnormalities: intracavitary mass (31%), intracavitary fluid (12.1%), myometrial lesion (31.03%), and adnexal mass (12.1%). Poorly differentiated endometrioid cancer (53.45%) represented the predominant histology. Of the 16 (27.5%) women with a thin/indistinct EMS, 5 women (8.6%) did not have any abnormal ultrasound findings whatsoever.
  
  
  CONCLUSIONS
  Women with type II endometrial cancer had a thin/indistinct EMS on TVUS in approximately 25% of cases. Lack of any ultrasound abnormality, including a thickened EMS, was noted in approximately 10% of patients. The use of TVUS, which has been of value in type I cancer, is limited in type II endometrial cancer. Therefore, endometrial sampling should be included in the evaluation of all women with postmenopausal bleeding, regardless of EMS thickness.
authors.affiliation: *Department of Obstetrics and Gynecology, Division of Gynecology Oncology, College of Medicine, The Ohio State University, Columbus, OH; and †Department of Obstetrics and Gynecology, Division of Gynecologic Specialties, University of California, Davis, Sacramento, CA.
authors.forename: Caroline C
authors.initials: CC
authors.lastname: Billingsley
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kenne
authors.forename: Catherine D
authors.initials: CD
authors.lastname: Cansino
authors.forename: Floor J
authors.initials: FJ
authors.lastname: Backes
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.forename: David M
authors.initials: DM
authors.lastname: O'Malley
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Copeland
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Fowler
authors.forename: Ritu
authors.initials: R
authors.lastname: Salani
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018262:Adenocarcinoma, Clear Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D019160:Endosonography / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D017698:Postmenopause; D011379:Prognosis; D012189:Retrospective Studies; D014621:Vagina / Q000000981:diagnostic imaging*