Is transvaginal ultrasound an appropriate screening tool for endometrial cancer in asymptomatic postmenopausal women? A case report

Abstract

A 55-years-old woman menopausal for the last 6 years discovered to have an endometrial thickness (ET) > 12 mm (suspected endometrial polyp) during routine evaluation in the gynaecology clinic using the transvaginal ultrasound (TVS). Departmental ultrasound confirmed the same TVS findings and suggested the presence of endometrial polyp as the main cause of the ET. Based upon the patient's risk factors (diabetic, hypertensive, obese with family history of endometrial cancer), a departmental decision was taken to proceed for diagnostic hysteroscopy and polypectomy after informed written consent. Large endometrial polyp and submucosal fibroid were found and excised during hysteroscopy. The histopathological results confirmed the intraoperative diagnosis of the endometrial polyp and submucosal fibroid. This report supports the American College of Obstetricians and Gynecologists recommendations and highlights that the TVS is not an appropriate screening tool for asymptomatic postmenopausal women. In addition, the ET > 4 mm in asymptomatic postmenopausal women does not need evaluation.

Keywords

• asymptomatic
• endometrial cancer
• postmenopausal
• screening
• tvs