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Re: Complex Hyperplasia With atypia in a 29 years old! From: ainsron@msn.com Sun Jul 9 14:49:52 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: GYN: OCPs OTC" Previous message: ainsron@msn.com: "Re: Ob/Gyn programs for Palm" In reply to: Joanne Bulley, MD: "Re: Complex Hyperplasia With atypia in a 29 years old!" Next in thread: Joanne Bulley, MD: "Re: Complex Hyperplasia With atypia in a 29 years old!" I think the other point to this discussion is that an endometrial pipelle diagnosis of hyperplasia is not to be used as the gold standard for these types of patients. You have only sampled a small area of the uterus and how can you know that it is the "worst area?" I would go the next step and hysteroscope these patients before deciding that medical therapy is reasonable. >I have had 2 patients in the last 3 years who presented with hyperplasia. >One had simple hyperplasia without atypia. Treated with six months of >Megace. From all the complaints, I believe she took it. Then repeat pipelle >shows again simple without . After discussion, she wanted Hyst. TAH and >BSO. Path = Grade one Endometial cancer. > >Other patient, complex hyperplasia with atypia, treated with Megace. 6 >months later pipelle unchanged. TAH & BSO Path = Grade one endometrial >cancer. > >My point is not that you shouldn't try medical therapy on these patients, >but that you MUST re biopsy at the end of treatment and if you don't see the >expected result, do a TOTAL EXCISIONAL BIOPSY. > >Dan -- Ronald E. Ainsworth, MD Next message: art fougner, md: "Re: GYN: OCPs OTC" Previous message: ainsron@msn.com: "Re: Ob/Gyn programs for Palm" In reply to: Joanne Bulley, MD: "Re: Complex Hyperplasia With atypia in a 29 years old!" Next in thread: Joanne Bulley, MD: "Re: Complex Hyperplasia With atypia in a 29 years old!"

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