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GYN: Complex Endometrial HyperplasiaFrom: Garry Siegel (garrys@mindspring.com)Sat Feb 26 21:24:35 2000
53 YO menopausal woman on Prempro for a while, had unscheduled bleeding after being amenorrheic. Her biopsy came back as complex endometrial hyperplasia with mild atypia. In the microscopic description (I don't have it with me at this time), there was a comment about necrosis. I think that she needs a D anc C to exclude endometrial cancer, prior to hysterectomy. My questions: 1. Would you do a concurrent hysteroscopy? Normally, I always do. Is there any concern about instilling fluid into the uterus and "back washing" potential cancer? 2. Would anyone do a D and C with a frozen section, and if negative for malignancy, proceed with a simple TVH or TAH w or w/o BSO, depending on patient preference (I'll advise the BSO). 3. Would anyone go straight to hyst without a D and C? Garry PS--the pathology lab is an out of town one, so while I can call the pathologist, I don't know him/her. I could request the slides and look at them with a local pathologist.
-- Garry E. Siegel, M.D., F.A.C.O.G. Roswell, GA Private Practice
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