The simplest answer to this clinical question would be a resounding yes. The concern is the possibility of malignancy located in the polyp. However, the presence of cancer cells in endometrial polyps is very rare. Dockerti Ferris in 1944 established diagnostic criteria for adenocarcinoma originated in an endometrial polyp. First, the carcinoma must be limited to a portion of the polyp, second, the base of the polyp should be free of cancer cells and third, the endometrium surrounding the base of the polyp should be normal.
The recommended procedure is hysteroscopy polypectomy and the risk of encountering a malignant lesion should not be the only criteria to value when deciding to offer polypectomy. Therefore, several questions arise when considering a polypectomy:
1. What are the suggested clinical indications for endometrial polypectomy?
2. What is the rate of atypical endometrial hyperplasia and endometrial cancer in asymptomatic women with endometrial lining less than 4mm?
3. What is the incidence of atypical endometrial hyperplasia and endometrial cancer in patients with hysteroscopically benign appearing endometrial polyps?
4-Cost of hysteroscopy compared to expectant management
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