Exposition of an endometrial polyp on ultrasound

Jake Wheater, Michelle Hood, Radiology Sheffield Teaching hospitals NHS Trust

An Endometrial Polyp (EP) is a mass situated within the lining of the endometrium, affecting premenopausal and postmenopausal women, specifically those treated with tamoxifen (Bates, 1997; Wethington et al., 2011). It is estimated that around 25% of women have an EP (Sherman et al., 2002), which are a predominately benign overgrowth of endometrial cells, however a malignant risk exists (1 - 3%) (Laughlin-Tommaso, 2015; Machtinger at al., 2005). Commonly, endometrial polyps may be difficult to differentiate between endometrial hyperplasia, prolapsed submucosal fibroids and endometrial carcinoma (Kelly, Dobbs and McCluggage, 2007). Malignancy risk, alongside symptoms such as menorrhagia and infertility, categorise EP’s as a pathology that requires an early diagnosis to aid best treatment. Ultrasound (US) is the first-choice modality for assessment of suspected EP’s and pelvic abnormalities (NICE, 2016), with large studies proving it highly sensitive (Lee et al., 2003). This work focuses on US in a patient with an EP and how US imaging, plus recent US developments can help to aid diagnosis and improve management. Overall, US is arguably the most complete imaging modality for endometrial assessment and with current technological developments, supported by future research and proactive changes to the current tentative treatment pathway, US can become undeniably valuable. Additionally, this work draws a basic conclusion on the treatment and management of this patient whilst also analysing the use of other appropriate imaging adjuncts.

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