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Re: Gyn: Complex hyperplasia in a polyp From: Gordon Goldman (obgyndoc@swbell.net) Sat Oct 20 20:37:01 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R. Daniel Braun: "Re: Uterus in or out?" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: 100 lbs wieght gain, o.p. multip" In reply to: Garry E. Siegel, M.D.: "Gyn: Complex hyperplasia in a polyp" Why not offer her all of the above? Gordon On Oct 20, 2007, at 2:10 PM, Garry E. Siegel, M.D. wrote: > 49 YO P1001, menopausal, S/P Tamoxifen a few years ago for treatment > after breast cancer. She is having no bleeding. > > She had been seen by a now-retired gynecologist from our community, > and > had a 17 mm. or so endometrium for a good while. A biopsy was > negative, and she didn't withdraw to Provera. > > When I first saw her and reviewed the records, I told her that I was > worried about her endometrium given Tamoxifen usage. A saline > sonogram > showed a 3 cm. or so polyp. > > At H-scope, she had a broad-based anterior wall polyp that I had to > trip/shave with the resectoscope. The rest of the endometrium was > flat. > > ECC, endo curretings negative. > > Polyp--Complex hyperplasia, mucinous change, no atypia. > > I am not 100& sure that I was able to trip the entire polyp, as it > was a > long resection. My guess is that I totally excised it. > > Would you: > > 1. Do nothing? > 2. Repeat an ultrasound for thickness in a couple of months? > 3. Repeat a saline ultrasound in a couple of months? > 4. Repeat a H-scope in a couple of months? > 5. Offer hysterectomy? > 6. High-dose progestin Rx? > 7. Other? > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA Next message: R. Daniel Braun: "Re: Uterus in or out?" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: 100 lbs wieght gain, o.p. multip" In reply to: Garry E. Siegel, M.D.: "Gyn: Complex hyperplasia in a polyp"

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