Snapshot
- A 60-year-old G0 female was found on outpatient endometrial biopsy to have abnormal proliferation of stromal and glandular endometrial elements.
Overview
Introduction
- An estrogen-dependent hyperplasia affecting mainly postmenopausal women
- incidence peaks between ages 50 and 60
- Risk factors include
- increased estrogen exposure
- unopposed postmenopausal estrogen replacement
- obesity
- nulliparity
- late menopause (after age 52)
- polycystic ovarian syndrome
- estrogen-producing tumors
- anovulation
- cancer syndromes
- hereditary nonpolyposis colon cancer
- increased estrogen exposure
- 3 classes of hyperplasia severity
- simple
- ↑ number of glands with no crowding
- complex
- ↑ number of branching glands with crowding
- atypical
- ↑ number of atypical glands with crowding
- simple
- highest risk of progression to endometrial cancer
Presentation
- Symptoms
- abnormal uterine bleeding
- post-menopausal bleeding
Evaluation
- Tissue biopsy
- gold standard
Treatment