Endometrial Hyperplasia Diagnosed Within an Endometrial Polyp
When endometrial hyperplasia is identified within an endometrial polyp or other discrete focal lesion, the diagnostic approach and subsequent management follow a distinct pathway — one that centres on direct visualisation of the uterine cavity before any further steps are taken.
Clinical Scenario
This protocol applies to cases where endometrial hyperplasia has been diagnosed within an endometrial polyp or other discrete focal lesion. Because the hyperplastic change is focal rather than diffuse, direct visualisation and biopsy of the uterine cavity using hysteroscopy is a key component of the evaluation at this stage.
Management Approach
Initial management involves complete removal of the polyp, together with tissue sampling from the background endometrium. The histological findings from this assessment then determine the course of subsequent management — the full algorithm for what follows is in the structured protocol.
References
Direct visualisation and biopsy of the uterine cavity using hysteroscopy should be undertaken where endometrial hyperplasia has been diagnosed within a polyp or other discrete focal lesion.
Complete removal of the uterine polyp(s) is recommended and an endometrial biopsy should be obtained to sample the background endometrium.
Subsequent management should be according to the histological classification of endometrial hyperplasia.
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