Endometrial cancer following endometrial resection |
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Authors: | Giorgia Gaia Revaz Botchorishvili Michel Canis Benoit Rabischong Kris Jardon Juan Raul Escalona Guy Lesec Frederic Penault-Llorca Pierre Dechelotte Jean Luc Pouly Gérard Mage |
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Institution: | 1. Department of Obstetrics and Gynecology, Polyclinique de l’H?tel-Dieu, CHU Clermont-Ferrand, Université d’Auvergne, Boulevard Leon Malfreyt, 63058, Clermont-Ferrand, Cedex1, France 2. Institute of Anatomy and Pathological Cytology, 2, av Victoria, 03200, Vichy, France 3. Centre Jean Perrin, 58, rue Montalembert, B.P. 392, 63011, Clermont-Ferrand, France 4. Department of Pathological Anatomy, CHU Clermont-Ferrand, Université d’Auvergne, Boulevard Leon Malfreyt, 63058, Clermont-Ferrand, Cedex1, France
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Abstract: | Endometrial ablation has emerged as a viable alternative to hysterectomy in the treatment of medically intractable dysfunctional
uterine bleeding. However, this procedure cannot guarantee complete removal of the entire endometrium. Cases of endometrial
cancer after endometrial ablation have been reported in the literature. We reviewed the cases of patients who underwent hysteroscopic
endometrial ablation by endometrial resection for abnormal uterine bleeding from 1994 to 2005 at the Department of Obstetrics
and Gynecology, Polyclinique, Clermont-Ferrand University. Of the 3769 patients having had hysteroresections, four developed
endometrial cancer after complete endometrial ablation (1.06 out of 1000). All four of these patients showed histological
evidence of endometrial polyps at endometrial resection, and all of them presented risk factors for endometrial carcinoma,
such as obesity and/or arterial hypertension. Endometrial cancer after hysteroscopic endometrial ablation is a rare but possible
occurrence, even a long time after the operation. Close monitoring of patients who have undergone endometrial ablation for
endometrial polyps and who present risk factors, such as obesity or hypertension, even after apparent total ablation of the
endometrium is strongly recommended, independently of the presence of abnormal bleeding that can represent a late symptom
of advanced endometrial cancer. |
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Keywords: | Endometrial ablation Endometrial carcinoma Endometrial polyps Endometrial resection |
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