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Endometrial Polyps
Endometrial Polyps
DEFINITION
Benign localized overgrowth of endometrial glands and stroma,
covered by epithelium, projecting above the adjacent epithelium
or
An endometrial polyp or uterine polyp is a mass in the inner
lining of the uterus.
They may have a large flat base (sessile) or be attached to the
uterus by an elongated pedicle (pedunculated) Pedunculated
polyps are more common than sessile ones. They range in size
from a few millimeters to several centimeters.
If pedunculated, they can protrude through the cervix into
the vagina
RISK FACTORS/ AETIOLOGY
No definitive cause of endometrial polyps is known, but they
appear to be affected by hormone levels and grow in response to
circulating estrogen
NOTE
The use of an intrauterine system containing levonorgestrel in
women taking tamoxifen may reduce the incidence of polyps.
EPIDEMIOLOGY
More common in women > 40
Endometrial polyps occur in up to 10% of
women.
It is estimated that they are present in 25% of
women with abnormal vaginal bleeding.
CLINICAL FEATURES
They often cause no symptoms, but where they occur
may present with:
irregular menstrual bleeding
They are round or oval and measure between a few millimeters and
several centimeters in diameter
They are usually red/brown color of the surrounding endometrium the
large ones can appear darker red
If they are pedunculated, they are attached by a thin stalk (pedicle). If
they are sessile, they are connected by a flat base to the uterine wall.
Pedunculated polyps are more common than sessile ones.
ENDOMETRIAL POLYPS
DIFFERENTIAL DIAGNOSIS
Endometrial hyperplasia
– diffuse process, majority of fragments in curettage,
absence of thick walled vessels
polypoid endometrial carcinoma
Adenosarcoma