2021 Volume 37 Issue 1 Pages 149-153
Preoperative diagnosis of small uterine endometrial lesions by endometrial curettage biopsy can be difficult because tissue from localized lesions may not be obtained by this procedure. We here report a case of atypical endometrial hyperplasia in an endometrial polyp that was not diagnosed by several endometrial curettage biopsies but was finally diagnosed by resectoscopic partial resection. A 54-year-old woman, gravida 2, para 2 was referred to our hospital because cervical cytology had shown atypical glandular cells-favoring neoplasia. Cervical and endometrial biopsies obtained in our hospital yielded only normal tissue and MRI examination showed no obvious abnormalities. Hysteroscopy revealed a polypoid lesion near the ostium of the left fallopian tube, prompting repeat endometrial curettage biopsy. However, it proved difficult to collect a sample from that polypoid lesion, which was therefore removed via a resectoscope. Histological examination of the specimen thus obtained resulted in a diagnosis of atypical endometrial hyperplasia in an endometrial polyp. Abdominal simple total hysterectomy and bilateral salpingo-oophorectomy was therefore performed. The final pathological diagnosis was also atypical endometrial hyperplasia. We therefore suggest that removal of specimens via a resectoscope may be a useful means of diagnosing endometrial lesions from which it is difficult to collect tissue by endometrial curettage.