EP22.33: Surprising pathological diagnosis of suspicious endometrial polyp with normal result of dilatation and curettage done four times

A 75-year-old patient was referred to hospital for the fifth time due to presence of endometrial hyperplasia. The gynecological history included two natural labours, no operational gynecological procedures, no complaints reported (i.e. vaginal bleeding). The ultrasound exam revealed a large polyp (50x54x50mm) in the cavity of uterus with suspicious, reach vascularity. The typical for polyp, one branch vascularization was originating from the front wall of the uterus. It was decided to remove the lesion by dilatation and curettage (D&C) during which it turned out that the lesion was not possible to be removed. As the result of this procedure only very limited material was sent for pathological evaluation and no abnormal cells were detected in the specimen. The result of histopathology examination was “simple endometrial hyperplasia”, which was in accordance with results of previous four D&Cs. The next decided step was to perform resectoscopy, during which finally 40% of the polyp was successfully removed. The obtained material was sent for histopathological examination, the result of which was consistent with leiomyosarcoma. Further treatment was carried out in accordance with oncological recommendations. The described case indicates need for extended Doppler ultrasound diagnosis and removing suspicious endometrial pathologies by resectoscopy, to reach enough specimen for reliable pathological diagnosis in postmenopausal patients. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.