Concurrent endometrial carcinoma in hysterectomy specimens in patients with histopathological diagnosis of endometrial hyperplasia in curettage specimens.

Objectives: The purpose of this study was to appraise the presence of Endometrial Carcinoma (EC) sequence in patients undergoing hysterectomy for Endometrial Hyperplasia (EH).

Material And Methods: Eighty-two patients undergoing hysterectomy with the indication of EH based on endometrial curettage between January 2009 and December 2013 were analyzed respectively All patients with a diagnosis of EH were investigated for age, parity history of diabetes mellitus and hypertension. The histopathology of the hysterectomy specimens were compared with their curettage specimens.

Results: A total number of 82 women; 48 (58.5%) postmenopausal and 34 (41.5%) premenopausal were determined to have EH on histopathological evaluation of endometrial tissues obtained by endometrial curettage performed for evaluation of various bleeding abnormalities. Mean-age of patients was 54.6?8.7. Among 82 patients found to have EH on curettage specimens 39 had EC on hysterectomy specimens (39/82. 47.5%). Consequently we determined well differentiated endometrial adenocarcinoma in 66% (35/53) of the patients with hyperplasia with atypia (17/35. 48.5% Grade 1 and 18/35.51.4% Grade 2) and 13.7% (4/29) hyperplasia without atypia (4/4.100% Grade 1).

Conclusions: Postoperative diagnosis of endometrial pathology might be different from that of preoperative especially in cases with complex EH with atypia. Our study indicated that most of women diagnosed preoperatively with Atypical endometrial hyperplasia (AEH) may have a cancer at final examination of hysterectomy specimens. It may be useful to operate patients with AEH in specific centers because of invasive endometrial cancer risk in final histopathological evaluation.