scholarly journals Endometrial cancer: Diagnostic methods in postmenopausal vaginal bleeding

2003 ◽  
Vol 11 (2) ◽  
pp. 97-101
Author(s):  
Aljosa Mandic ◽  
Tamara Vujkov
Keyword(s):  
Endometrial Cancer ◽  
Vaginal Bleeding ◽  
Transvaginal Ultrasound ◽  
Correct Diagnosis ◽  
False Negative ◽  
Endometrial Biopsy ◽  
Diagnostic Methods ◽  
Histological Evaluation ◽  
Leading Symptom ◽  
Postmenopausal Vaginal Bleeding

Postmenopausal vaginal bleeding (PMB) is the leading symptom of endometrial cancer. More than 70% of patients with endometrial cancer are postmenopausal. Despite PMB as a leading symptom in diagnosis of endometrial cancer, PMB could be caused by some benign processes in endometrium such as hyperplasia and focal endometrial disease, such as a polyp. The golden standard for histological evaluation of the endometrium is curettage. Transvaginal ultrasound (TVS) and measurement of endometrium thickness is also one of the favored methods in the last decade. Sonographic imaging of the endometrium can be extremely helpful, because endometrial cancer is nearly always associated with thickening and heterogeneity of the endometrium except in case of atrophy-associated adenocarcinoma of the endometrium, which is not associated with thickening. Hysteroscopy found place as a favored method in diagnosis of focal endometrial lesions. Saline infusion sonohysterography (SIS) is a relatively new imaging procedure. The SIS will show whether the endometrium is diffusely thickened, in which case curettage would be the next step, or focally thickened, in which case hysteroscopy with biopsy would be the next step. Combination of some diagnostic procedures, such as TVS, SIS, hysteroscopy, endometrial biopsy and curettage, should decrease false positive and false negative results which may affect the correct diagnosis and treatment.

Vaginal bleeding during menopause hormone therapy. Is it always endometrial cancer? How to choose the appropriate tactics for examination and management of patients?

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 37-43
Author(s):  
Anna E. Protasova ◽  
Irina A. Solntseva ◽  
Ekaterina N. Vandeeva
Keyword(s):  
Endometrial Cancer ◽  
Hormone Therapy ◽  
Genital Tract ◽  
Vaginal Bleeding ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menopausal Hormone Therapy ◽  
Modern Analysis ◽  
Menopause Hormone Therapy ◽  
Postmenopausal Vaginal Bleeding

The article provides an overview of the possible causes of bleeding from the genital tract in peri- and postmenopausal women. The correct approach to patients with abnormal uterine bleeding during menopausal hormone therapy is described. A modern analysis of data on the diagnosis and treatment of postmenopausal vaginal bleeding against the background of menopausal hormone therapy was carried out. The modern possibilities of endometrial diagnostics and treatment are shown.

Endometrial Ultrasonography - An Alternative to Invasive Assessment in Women with Postmenopausal Vaginal Bleeding

1996 ◽  
Vol 82 (1) ◽  
pp. 38-39 ◽  
Author(s):  
Silvia Cecchini ◽  
Stefano Ciatto ◽  
Rita Bonardi ◽  
Grazia Grazzini ◽  
Antonia Mazzotta
Keyword(s):  
Endometrial Cancer ◽  
General Anesthesia ◽  
Endometrial Carcinoma ◽  
Vaginal Bleeding ◽  
Endometrial Thickness ◽  
Diagnostic Assessment ◽  
Vaginal Sonography ◽  
Postmenopausal Vaginal Bleeding

Aims and background To test the reliability of endometrial sonography in selecting women with abnormal postmenopausal vaginal bleeding for further diagnostic assessment. Methods Endometrial thickness was measured in 368 consecutive women by abdominal or vaginal sonography prior to invasive assessment (hysteroscopy, curettage). The association of abnormal endometrial thickness (4 mm or greater) with endometrial cancer was determined. Results Abnormal endometrial thickness was observed in 116 of 368 women. Subsequent assessment diagnosed endometrial carcinoma in 16 subjects, 15 of whom had abnormal endometrial thickness. One case with normal endometrial thickness was suspected at sonography because of the irregular appearance of the endometrium. Conclusions Had it been used to select subjects for further assessment, sonography would have missed no cancer, and unnecessary invasive assessment (under general anesthesia in 20% of cases) would have been spared in 68% (251/368) of the subjects. Endometrial sonography should be routinely used to select women with postmenopausal vaginal bleeding for further investigations.

scholarly journals A molar pregnancy detected by following irregular vaginal bleeding after a first trimester evacuation: rare case report

2019 ◽  
Vol 8 (6) ◽  
pp. 2549
Author(s):  
Meena Bhati Salvi
Keyword(s):  
Case Report ◽  
Vaginal Bleeding ◽  
Transvaginal Ultrasound ◽  
Correct Diagnosis ◽  
First Trimester ◽  
Molar Pregnancy ◽  
Sequence Of Events ◽  
Beta Hcg ◽  
Surgical Evacuation ◽  
Invasive Mole

In this case report summarizes the sequence of events that led to detection of a molar pregnancy missed by ultrasound and initial pathology examination. A 29 years old Asian nulliparous patient came to our clinic with missed period. On beta HCG she was 6 weeks pregnant. After 20 days she was diagnosed with 7 weeks missed abortion on ultrasound. surgical evacuation done for same. After 3 weeks she came with irregular vaginal bleeding. After physical and vaginal examination Beta HCG done, which was very high. On transvaginal ultrasound partial molar pregnancy was detected, so she was immediately admitted and repeat surgical evacuation was done. Histopathology report confirmed partial molar pregnancy which was not detected in previous report. She was regularly followed up with Beta HCG value up to 1 year which declined dramatically. Though molar pregnancy is rare, but it has the potential to develop into invasive mole, so any abnormal bleeding post evacuation should be followed up properly. Beta HCG values and histopathological evaluation is important for correct diagnosis and follow up.

scholarly journals Accuracy of Five Different Diagnostic Techniques in Mild-to-Moderate Pelvic Inflammatory Disease

2002 ◽  
Vol 10 (4) ◽  
pp. 171-180 ◽  
Author(s):  
Hernando Gaitán ◽  
Edith Angel ◽  
Rodrigo Diaz ◽  
Arturo Parada ◽  
Lilia Sanchez ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pelvic Inflammatory Disease ◽  
Clinical Diagnosis ◽  
Inflammatory Disease ◽  
Performance Test ◽  
Transvaginal Ultrasound ◽  
Lower Abdominal Pain ◽  
Endometrial Biopsy ◽  
Diagnostic Methods ◽  
Cross Sectional

Objective:To evaluate the clinical diagnosis of pelvic inflammatory disease (PID) compared with the diagnosis of PID made by laparoscopy, endometrial biopsy, transvaginal ultrasound, and cervical and endometrial cultures.Study design:A diagnostic performance test study was carried out by cross-sectional analysis in 61 women. A group presenting PID (n= 31) was compared with a group (n= 30) presenting another cause for non-specific lower abdominal pain (NSLAP). Diagnosis provided by an evaluated method was compared with a standard diagnosis (by surgical findings, histopathology, and microbiology). The pathologist was unaware of the visual findings and presumptive diagnoses given by other methods.Results:All clinical and laboratory PID criteria showed low discrimination capacity. Adnexal tenderness showed the greatest sensitivity. Clinical diagnosis had 87% sensitivity, while laparoscopy had 81% sensitivity and 100% specificity; transvaginal ultrasound had 30% sensitivity and 67% specificity; and endometrial culture had 83% sensitivity and 26% specificity.Conclusions:Clinical criteria represent the best diagnostic method for discriminating PID. Laparoscopy showed the best specificity and is thus useful in those cases having an atypical clinical course for discarding abdominal pain when caused by another factor. The other diagnostic methods might have limited use.

scholarly journals Clear Cell Carcinoma of the Endometrium in a Patient Presenting with Postmenopausal Bleeding but Negative Endometrial Biopsy

2021 ◽  
pp. 1768-1772
Author(s):  
Swechchha Silwal ◽  
Sumeet Kumar Yadav ◽  
Benedict Amalraj ◽  
Mohamed Mandeel ◽  
Geetha Krishnamoorthy
Keyword(s):  
Endometrial Cancer ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Endometrial Biopsy ◽  
Postmenopausal Bleeding ◽  
Gynecological Malignancy ◽  
The Usa

Endometrial carcinoma is the most common gynecological malignancy in the USA with approximately 66,570 cases and 12,940 deaths in 2020. Clear cell carcinoma (CCC) of the endometrium is an estrogen-independent type II endometrial cancer which accounts for <5% of endometrial cancer. When diagnosed roughly, 45% of patients have extrauterine metastases. Current American College of Obstetrics and Gynecology guidelines recommend transvaginal ultrasound for postmenopausal bleeding and a biopsy for those with endometrial thickness >5 mm. However, we present a case of a postmenopausal woman with a history of fibroid where endometrial biopsy has failed to make diagnosis twice. Hence, further testing should be performed in patients with unexplained postmenopausal bleeding including vaginal hysterectomy with lymph node dissection.

scholarly journals DEveloping Tests for Endometrial Cancer deTection (DETECT): protocol for a diagnostic accuracy study of urine and vaginal samples for the detection of endometrial cancer by cytology in women with postmenopausal bleeding

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050755
Author(s):  
Eleanor R Jones ◽  
Suzanne Carter ◽  
Helena O'Flynn ◽  
Kelechi Njoku ◽  
Chloe E Barr ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Diagnostic Accuracy ◽  
Cancer Detection ◽  
Transvaginal Ultrasound ◽  
Primary Objective ◽  
Endometrial Biopsy ◽  
Test Accuracy ◽  
Diagnostic Accuracy Study ◽  
Postmenopausal Bleeding ◽  
Accuracy Study

IntroductionPostmenopausal bleeding (PMB), the red flag symptom for endometrial cancer, triggers urgent investigation by transvaginal ultrasound scan, hysteroscopy and/or endometrial biopsy. These investigations are costly, invasive and often painful or distressing for women. In a pilot study, we found that voided urine and non-invasive vaginal samples from women with endometrial cancer contain malignant cells that can be identified by cytology. The aim of the DEveloping Tests for Endometrial Cancer deTection (DETECT) Study is to determine the diagnostic test accuracy of urine and vaginal cytology for endometrial cancer detection in women with PMB.Methods and analysisThis is a multicentre diagnostic accuracy study of women referred to secondary care with PMB. Eligible women will be asked to provide a self-collected voided urine sample and a vaginal sample collected with a Delphi screener before routine clinical procedures. Pairs of specialist cytologists, blinded to participant cancer status, will assess and classify samples independently, with differences settled by consensus review or involving a third cytologist. Results will be compared with clinical outcomes from standard diagnostic tests. A sample size of 2000 women will have 80% power to establish a sensitivity of vaginal samples for endometrial cancer detection by cytology of ≥85%±7%, assuming 5% endometrial cancer prevalence. The primary objective is to determine the diagnostic accuracy of urogenital samples for endometrial cancer detection by cytology. Secondary objectives include the acceptability of urine and vaginal sampling to women.Ethics and disseminationThis study has been approved by the North West–Greater Manchester West Research Ethics Committee (16/NW/0660) and the Health Research Authority. Results will be disseminated through publication in peer-reviewed scientific journals, presentation at conferences and via charity websites.Trial registration numberISRCTN58863784.

scholarly journals Development of endometrial cancer after long-term usage of the levonorgestrel-releasing intrauterine system

2021 ◽  
Vol 14 (5) ◽  
pp. e242094
Author(s):  
Alexander Steshenko ◽  
Leila Hanna ◽  
Damian Collins
Keyword(s):  
Endometrial Cancer ◽  
Protective Effect ◽  
Vaginal Bleeding ◽  
Scientific Evidence ◽  
Laparoscopic Hysterectomy ◽  
Endometrial Biopsy ◽  
Endometrioid Adenocarcinoma

A 52-year-old long-term user of the levonorgestrel-releasing intrauterine system (LNG-IUS) presented with vaginal bleeding. Endometrial biopsy was performed and revealed endometrioid adenocarcinoma. The patient had a laparoscopic hysterectomy and bilateral salpingo-oophorectomy. Endometrial cancer is rare in women with LNG-IUS as only seven cases have been published in the literature. Although scientific evidence shows LNG-IUS has a protective effect on the endometrium from developing cancer, our report highlights the importance of clinicians to be vigilant in cases of women with LNG-IUS who develop intermittent vaginal bleeding.

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