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Re: Complex hyperplasia in a polyp From: Atkinson, Samuel M (ATKINSONS@ecu.edu) Mon Oct 22 14:10:37 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff: "Re: Complex hyperplasia in a polyp" Previous message: Atkinson, Samuel M: "Re: Spam warning for Namibian Obstetricians" Next in thread: Richard Chudacoff: "Re: Complex hyperplasia in a polyp" Reply: Richard Chudacoff: "Re: Complex hyperplasia in a polyp" The Tamoxophen causes a false shadow that appears on ultrasound and is called thickened endometrium. Many a uterus has been removed, only to find an organized scarred endometrium..no hyperplasia. A negative endometrial Bx is sufficient. Unless you remove every uterus you see, an occaisional endometrial cancer may slip through ut a negative endo bx is sufficient. Re chk in 6 mos and if bleeding, repeat bx. sAm ________________________________ From: ob-gyn-l@obgyn.net on behalf of Garry E. Siegel, M.D. -- ________________________________ Sent: Sat 10/20/2007 3:10 PM To: Multiple recipients of list OB-GYN-L Subject: Gyn: Complex hyperplasia in a polyp 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: Richard Chudacoff: "Re: Complex hyperplasia in a polyp" Previous message: Atkinson, Samuel M: "Re: Spam warning for Namibian Obstetricians" Next in thread: Richard Chudacoff: "Re: Complex hyperplasia in a polyp" Reply: Richard Chudacoff: "Re: Complex hyperplasia in a polyp"

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