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Endometrial Hyperplasia

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Hysteroscopy

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Abstract

Endometrial hyperplasia (EH) represents a spectrum of irregular morphological alterations, whereby abnormal proliferation of the endometrial gland results in increased thickness of endometrial tissue with alterations of glandular architecture and in an increase in gland-to-stroma ratio when compared to endometrium from the proliferative phase of the cycle. There are two different systems to classify endometrial hyperplasia, the World Health Organization (WHO) schema and the endometrial intraepithelial neoplasia (EIN). Endometrial hyperplasia’s risk factors are the same of endometrial cancer type 1 (conditions associated with steroid hormone imbalances). Endometrial hyperplasia is often suspected in women with abnormal uterine bleeding and diagnosis is performed by transvaginal ultrasonography and hysteroscopy. The confirmation of diagnosis requires histological analysis of endometrial tissue. Endometrial hyperplasia without atypia’s treatment focuses on hormonal therapy which consists in continuous oral and local intrauterine (levonorgestrel-releasing intrauterine system [LNG-IUS]) progestogens. The standard treatment option for atypical endometrial hyperplasia is total hysterectomy with peritoneal cytology. In patients who wish a pregnancy is possible a fertility-sparing therapy which consist in the combination between systemic or locoregional medical treatment and a conservative surgical approach (hysteroscopic resection of the tumor lesion).

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Authors and Affiliations

  1. USL Sud Est Toscana, Ospedale Santa Margherita di Cortona, N.A. Fratta 145, 52044, Cortona, AR, Italy

    Luca Mencaglia, Francesca Ciociola & Stefania Magnolfi

Authors
  1. Luca Mencaglia
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  2. Francesca Ciociola
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  3. Stefania Magnolfi
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Corresponding author

Correspondence to Luca Mencaglia .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynaecology, Ospedale Vito Fazzi, Lecce, Italy

    Andrea Tinelli

  2. Hysteroscopy Unit, Gutenberg Institute, Malaga, Spain

    Luis Alonso Pacheco

  3. Hysteroscopy Unit, Hospital Del Mar, Barcelona, Spain

    Sergio Haimovich

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Mencaglia, L., Ciociola, F., Magnolfi, S. (2018). Endometrial Hyperplasia. In: Tinelli, A., Alonso Pacheco, L., Haimovich, S. (eds) Hysteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-57559-9_27

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  • DOI: https://doi.org/10.1007/978-3-319-57559-9_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-57558-2

  • Online ISBN: 978-3-319-57559-9

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