1/8. Balloon thermoablation in a woman with complex endometrial hyperplasia with atypia. A case report.BACKGROUND: Endometrial ablation is an alternative to hysterectomy in patients with menorrhagia refractory to medical therapy. The histologic changes in the hyperplastic endometrium secondary to endometrial ablation are not well understood. CASE REPORT: A 44-year-old woman, gravida 4, para 4, had menorrhagia, was at high risk for medical treatment and underwent thermal balloon ablation. The dilatation and curettage specimen at the time of the procedure revealed complex hyperplasia of the endometrium with atypia. Subsequently a hysterectomy was performed, and the pathology specimen showed scarring, fibrosis and focal, weakly proliferative phase endometrium. There was no evidence of hyperplasia or malignancy. CONCLUSION: Endometrial ablation with a thermal balloon seems to have resulted in resolution of endometrial hyperplasia. However, hyperplasia of the endometrium should still be a contraindication to such a procedure because of the inability to accurately assess the endometrium after ablation.- - - - - - - - - - ranking = 1keywords = endometrial ablation, ablation (Clic here for more details about this article) |
2/8. endometrial hyperplasia with berrylike squamous metaplasia and pilomatrixomalike shadow cells. Report of an intriguing cytohistologic case.BACKGROUND: The usefulness of endometrial cytology as a diagnostic method in asymptomatic women, especially in postmenopause, in the interpretation of composite pictures characterized by borderline features between atypical hyperplasia and well-differentiated adenocarcinoma, especially if associated metaplastic features are present, is somewhat controversial. CASE: An asymptomatic, 50-year-old, postmenopausal woman underwent a Pap smear and endometrial cytology for routine screening, disclosing three-dimensional, sometimes pseudopapillary groupings of hyperplastic endometrial glandular cells with focal atypia in direct continuity with large, squamoid cells of the keratinizing type and shadow cells. Histologic examination of endometrial tissue was advised, and two subsequent endometrial biopsies and hysteroscopic ablation were performed. The borderline character of the lesion (complex atypical hyperplasia vs. well-differentiated adenocarcinoma) with concomitant squamous metaplasia and pilomatrixomalike shadow cells prevented diagnostic agreement between several pathologists. CONCLUSION: Diagnostic cytology with direct endometrial sampling represents a valuable diagnostic screening tool for the differential diagnosis between normal and pathologic endometrium, a mucosal picture that deserves a subsequent (histologic) diagnostic procedure. In a few cases, as in the one presented above, even histologic examination, especially of so-called borderline lesions, reveals squamous or other types of metaplasia that can lead to interobserver discrepancies.- - - - - - - - - - ranking = 0.00060656163174175keywords = ablation (Clic here for more details about this article) |
3/8. Endometrial carcinoma after endometrial resection for dysfunctional uterine bleeding.BACKGROUND: Endometrial destruction is an accepted conservative surgical approach for women with dysfunctional uterine bleeding. However, this procedure cannot guarantee complete removal of the entire endometrium. The possibility exists that endometrial carcinoma may develop even years after such procedure. CASE: We report on a case of endometrial carcinoma, which was diagnosed 3 years after hysteroscopic resection of the endometrium for dysfunctional uterine bleeding in a patient with no risk factors. CONCLUSION: Endometrial carcinoma after hysteroscopic endometrial ablation is still a possibility even when strict selection criteria are applied.- - - - - - - - - - ranking = 0.99514750694607keywords = endometrial ablation, ablation (Clic here for more details about this article) |
4/8. The process of carcinogenesis for endometrial adenocarcinoma could be short: development of a malignancy after endometrial ablation.Endometrial ablation has been proposed as an alternative to hysterectomy for the treatment of dysfunctional uterine bleeding. We describe what we believe to be the first reported case of an endometrial adenocarcinoma that may have developed shortly after endometrial ablation.- - - - - - - - - - ranking = 4.9763440963621keywords = endometrial ablation, ablation (Clic here for more details about this article) |
5/8. Endometrial ablation. A report of four cases.Three women had evidence of atypical endometrial hyperplasia at the time of endometrial ablation, discovered because they had mechanical preparation of the endometrium rather than medical preparation. In one of these patients, a frozen section revealed atypical endometrial hyperplasia, and the ablation was cancelled. A fourth woman had an unsuccessful endometrial ablation; repeat ablation was followed by nine months of amenorrhea, at which time she began spotting and requested a hysterectomy. The pathology report on the hysterectomy specimen revealed adenomatous hyperplasia. Gynecologists must be vigilant in their evaluation of the endometrium before, during and after endometrial ablation.- - - - - - - - - - ranking = 2.9890818906286keywords = endometrial ablation, ablation (Clic here for more details about this article) |
6/8. Not so benign endometrial hyperplasia: endometrial cancer after endometrial ablation.The masking or development of endometrial cancer after endometrial ablation is a concern often alluded to in discussions of complications of endometrial ablation. It is necessary to look for a common factor when this complication occurs. Six cases published in peer-reviewed literature were collected to establish a link between the development of endometrial cancer and endometrial ablation. Preexisting endometrial hyperplasia seems to be the common denominator, and should be considered a contraindication to endometrial ablation until more data are collected.- - - - - - - - - - ranking = 7.9611800555685keywords = endometrial ablation, ablation (Clic here for more details about this article) |
7/8. Successful treatment of recurrent uterine bleeding during tamoxifen therapy by endometrial ablation.Recurrent bleeding occurred in a premenopausal breast cancer woman during tamoxifen therapy. This bleeding required three curettages. Atypical hyperplasia and carcinoma were excluded, and the patient was prepared for endometrial ablation with two GnRH agonist injections. An endometrial ablation using the roller ball technique was carried out without complications. tamoxifen therapy was continued postoperatively. During 24 months' follow-up the patient experienced no bleeding and no endometrium was seen by sonography.- - - - - - - - - - ranking = 5.9708850416764keywords = endometrial ablation, ablation (Clic here for more details about this article) |
8/8. Venous embolism of diathermy evolved gases complicating endometrial ablation using glycine irrigant.A case is reported of venous gas embolism in a 44-year-old woman undergoing hysteroscopic endometrial ablation using glycine irrigation without gas insufflation. The postulated source of gases are the vapour and combustion products produced by the diathermy.- - - - - - - - - - ranking = 4.9757375347303keywords = endometrial ablation, ablation (Clic here for more details about this article) |