Histopathological Study of Endometrial Polyps and its Association With Cancer: Experience from a Tertiary Care Center in Coastal India

Abstract

Aim: Morphologic examination of endometrial polyps and assess the occurrence of endometrial cancer. Materials & Methods: One hundred sixty cases of endometrial polyps received at the department of Pathology of a tertiary care hospital over 31 months i.e., from January 2014 and July 2016 were analysed. The clinical data was retrieved from the medical records department. Results: Out of the 160 cases of endometrial polyps, 94.4% of the endometrial polyps were non neoplastic & 5.6% were neoplastic. The mean age of presentation of non-neoplastic polyps was 45 years (21-76 years) & neoplastic polyps was 52 years (42-62 years). The mean size of non-neoplastic polyp was 2.4 cm (0.5-9 cm) & neoplastic polyp was 4.5cm (1.5-9cm). The non-neoplastic polyps were benign endometrial glandular polyp (83.7%), leiomyomatous polyp (2.2%), adenomyomatous polyp (1.1%) & stromomyoma (0.5%). The neoplastic polyps encountered were endometrial carcinoma type 1 (1.67%), endometrial carcinoma type 2 (0.5%), endometrial stromal sarcoma (1.67%), adenosarcoma (0.5%) & malignant mixed mullerian tumor (0.5%). Post-menopausal bleeding was seen in 27% of patients. Immunohistochemistry was performed in 3 of the cases. Tamoxifen induced endometrial polyp were seen in 1.67%. Conclusion: Endometrial polyps are rarely associated with malignancy, as most of them are hyperplastic glandular polyps. Multiple risk factors such as age, multiparity, tamoxifen usage show higher association with malignancy. Post-menopausal bleeding cases needs to be thoroughly evaluated for presence of endometrial malignancy. Histopathological evaluation of resected polyps proves the nature of the disease.

Keywords

• endometrial carcinoma
• endometrial polyps
• malignant mixed mullerian tumor
• post-menopausal bleeding
• stromal sarcoma