Premalignant endometrial lesions are a typical sequence of atypical endometrial hyperplasia or intraepithelial neoplasia. Endometrial hyperplasia is characterized by the proliferation of endometrial glands, resulting in a higher than normal gland-to-stroma ratio.
Abnormal bleeding
The most significant and early sign of endometrial cancer
Occurs in about 80% of patients.
It could be in the form of premenstrual and postmenstrual bleeding besides intermenstrual spotting.
Excessive bleeding throughout the premenopausal years
Irregular vaginal discharge, particularly after menopause or intermittent spotting
Lower abdomen pain and cramps as a result of uterine contractions brought on by debris and blood sucked up behind a stenotic cervical os (hematometra).
Sepsis and the development of an abscess if the uterine contents are infected.
If you have any of these symptoms visit a Gynaecologist to be diagnosed and treated properly.
Endometrial hyperplasia develops as a result of constant estrogen stimulation that is unopposed by progesterone. This may be brought on by :
Endogenous estrogen due to prolonged anovulation linked to PCOS, or sources of exogenous estrogen.
Unopposed estrogen exposure in obesity because of the persistently elevated levels of estradiol
Ovarian tumors that secrete estradiol, like granulosa cell tumors
A pregnancy test to exclude pregnancy.
Assessment of the coagulation profile with total platelet counts, prothrombin time, and partial thromboplastin time to exclude coagulation and platelet disorders.
A complete blood count to assess anemia.
Imaging the endometrium
Hysteroscopy and direct biopsy sampling of the endometrium.
Fractional curettage
Pelvic and Endovaginal ultrasonography
Management options of premalignant endometrial lesions include :
Surgical Management :
Total hysterectomy is the current standard of care for premalignant lesions of the endometrium.
Abdominal hysterectomy
Vaginal hysterectomy
Minimally invasive procedures
Non-surgical Management :
Hormonal therapy
Aromatase inhibitors, gonadotropin-releasing hormone (GnRH) antagonists, and sulfatase inhibitors : To reduce estrogenic effects.
Progesterone derivatives such as medroxyprogesterone acetate (MPA) and megestrol acetate : To preserve fertility.
Selective estrogen receptor modulators (SERMS)
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