内膜ポリープ様隆起を呈した早期子宮体癌症例の診断に子宮鏡下手術が有用であった1例

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Objectives: Since the positive predictive value of endometrial biopsy for uterine corpus cancer without myometrial invasion is not high, early diagnosis is difficult. We report a case in which we diagnosed uterine corpus cancer by using hysteroscopic endometrial tissue biopsy 2 years after an initial visit.

Patient: A 61-year-old postmenopausal woman was referred for evaluation of positive endometrial cytology. Magnetic resonance imaging showed thickening of the endometrium, but repeated uterine curettage biopsies revealed no malignancy. We thought that collection of polypoid-like lesions would be difficult, and performed hysteroscopic endometrial tissue biopsy. Two endometrial polyps were excised, and through histopathological analysis of one polyp, we diagnosed endometrioid adenocarcinoma Grade 2. Radical surgery was performed for stage I A uterine corpus cancer, and the final diagnosis was uterine corpus cancer stage I A (pT1aN0M0), with endometrial adenocarcinoma Grade 2.

Conclusion: For uterine corpus cancer with suspected polypoid lesions and difficulty in diagnosis with uterine curettage, hysteroscopic endometrial biopsy can be useful.