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Re: GYN: Complex Endometrial Hyperplasia From: Bernard Cristalli (bcrist@club-internet.fr) Sun Feb 27 04:16:04 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Paul Prior MD: "Re: Opinions please!" Previous message: Bernard Cristalli: "Re: GYN: Hymenectomy" In reply to: Garry Siegel: "GYN: Complex Endometrial Hyperplasia" 2 or 3 cases have been published of post hysteroscopy cancer dissemination but I still do hysteroscopies in those cases. (Schmitz MJ Eur J Gynaecol Oncol 1994; 15: 121-4; and Egarter C Gynecol Oncol 1996; 63: 143-4) No frozen section In a young woman like this one a cancer would mandate a more radical intervention than a TVH. In an old, weak woman I'd do a straight TVH. That's what I did in a 150kgs one with respiratory distress in which the office sampling was unconclusive, the anesthesiologists allowed me one and only op. -- Bernard Cristalli MD AMACOG AIHP - ACCA Paris France Bernard.Cristalli@CliniquedelEssonne.fr http://www.CliniquedelEssonne.fr http://www.obgyn.net/corresp/cristalli.htm '64 Mk2 3.8 > De : garrys@mindspring.com Sun Feb 27 05:25:53 2000 > Répondre à : ob-gyn-l@obgyn.net > Date : Sat, 26 Feb 2000 22:24:50 -0600 > À : Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net> > Objet : GYN: Complex Endometrial Hyperplasia > > 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 > Next message: Paul Prior MD: "Re: Opinions please!" Previous message: Bernard Cristalli: "Re: GYN: Hymenectomy" In reply to: Garry Siegel: "GYN: Complex Endometrial Hyperplasia"

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