Risk of coexisting endometrial carcinoma in case of atypical endometrial ă hyperplasia diagnosed on total hysteroscopic resection

International audienceObjective: To evaluate the rate of coexisting endometrial carcinoma or ă atypical endometrial hyperplasia (AEH) residue in patients who had a ă total hysteroscopic resection with diagnosis of AEH and without ă suspicious lesions detected during hysteroscopy. ă Study design: This retrospective bicentric study included patients ă diagnosed with AEH on hysteroscopic resection products, and who ă subsequently underwent secondary hysterectomy. Cases of hysteroscopic ă appearance suggesting an endometrial carcinoma were excluded. ă Histopathological results of hysterectomy specimen determined the ă persistence or absence of AEH and the possible presence of coexisting ă endometrial carcinoma. ă Results: Thirty-two patients were selected. Histopathological analysis ă of hysterectomy specimens diagnosed an absence of AEH in 24/32 (75%) ă subjects, an AEH residue in 6/32 (18.8%) subjects and a coexisting ă endometrial carcinoma in 2/32 (6.2%) subjects. ă Conclusion: The risk of missing an endometrial carcinoma in patients ă diagnosed with AEH based on total hysterocopic resection is low when ă there is no suspicious hysteroscopic aspect, but this risk cannot be ă entirely excluded. Total hysteroscopic resection may be a possible ă alternative to hysterectomy in patients with AEH who refuse hysterectomy ă or are a high surgical risk. These patients require a close and long ă term follow-up due to the risks of residual lesion. (C) 2016 Elsevier ă Ireland Ltd. All rights reserved