Atypical and Malignant Endometrial Polyps

Under the action of certain factors, any neoplasm that has arisen in the body can take on a malignant form. This also applies to intrauterine polypous growths. Most often they are diagnosed in older women (menopause, postmenopause).

Diagnosis of malignant endometrial polyps is carried out using histological examination. The tissues collected during the hysteroscopy are sent for analysis. According to the results of histology, such precancerous conditions can be identified:

• Adenomatous neoplasm.
• Glandular polyp with cell proliferation.
• In situ cancer (initial forms of oncology).

According to studies, the main cause of the malignancy of benign growths is genetic and hormonal disorders. In the first case, it is a hereditary predisposition. The risk of cancer increases with the action of such factors:

• Endocrine pathology.
• Gynecological diseases.
• Inflammatory processes in the endometrium.
• Tumor lesions of the uterus and its appendages.

Of particular danger are uterine polyps in the period of menopause and arising on the background of endocrine disorders. The first signs of intrauterine pathologies include menstrual disorders. This is manifested by irregular or abundant menses. There may be nagging pain in the lower abdomen, increased vaginal discharge, weakness and general fatigue.

Pathology diagnostics is performed using transvaginal ultrasound. The diagnosis is confirmed by hysteroscopy followed by histological examination of the collected tissues.

The treatment is engaged in a gynecologist-oncologist. Removal of a malignant neoplasm and curettage of the uterine cavity is carried out. In the future, the patient is prescribed drug therapy for the correction of hormonal levels. Particular attention is paid to preventive measures: the normalization of body weight, the rejection of abortions, the timely treatment of gynecological and any other diseases of the body, regular examinations at the gynecologist.

Atypical endometrial polyp

Endometrial neoplasm with abnormal structures, resulting from tumor transformations and tissue inflammatory processes, is an atypical polyp. The presence of atypical cells indicates the risk of malignant degeneration of the growth.

Atypical (adenomatous) polyp can be formed from any type of tissue. Transformation is associated with the action of certain factors. Depending on the degree of structural change of the mucous membrane, there are two types of atypical hyperplasia:

• Simple - in the histological analysis, an increased number of glandular and stromal elements, but without a structurally modified endometrium. The glands have an increased mitotic activity. These may be glandular or glandular-cystic polyps.

• Difficult - endometrium with pronounced proliferation of the glandular component. There are signs of atypia at the tissue and cellular level. The invasion of the basement membrane of glandular structures is absent. Histology indicates the accumulation of abnormal cells, loss of polarity of the glands. Cellular atypia is characterized by the proliferation and distortion of the shape of glands with infiltrates and endometrial stroma.

Atypical changes are a precancerous condition, that is, an intermediate position between common forms of glandular hyperplasia and oncology. The malignant potential of atypical polyps is 30-50%.

[6], [7], [8]

Endometrial polyp without atypia

According to the histological classification, endometrial hyperplastic processes are divided into the following groups:

• Glandular cystic hyperplasia.
• Endometrial polyps: glandular, cystic, fibrous.
• Atypical hyperplasia (polyps, adenomatosis, etc.).

The first two groups act as a background for endometrial cancer and occur in 2-4% of cases. Atypical processes are characterized by impaired cell differentiation within the epithelial layer, that is, they are a precancer.

Endometrial polyp without atypia indicates a benign proliferation of mucosal tissue. Histological examination of tumors does not reveal malignant cells. The most secure growths are anomalies of the functional layer of the mucous glandular or fibrous nature.

For the treatment of polyps without atypia, their surgical removal and restoration of hormonal levels with the help of drugs are shown.

[9], [10], [11], [12], [13], [15]