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Hysteroscopy pp 261-267 | Cite as

Endometrial Hyperplasia

  • Luca Mencaglia
  • Francesca Ciociola
  • Stefania Magnolfi
Chapter

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).

Keywords

Endometrial hyperplasia Hysteroscopy Endometrial intraepithelial neoplasia Endometrial cancer Tumor Endometrial gland Menopause 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Luca Mencaglia
    • 1
  • Francesca Ciociola
    • 1
  • Stefania Magnolfi
    • 1
  1. 1.USL Sud Est ToscanaOspedale Santa Margherita di CortonaCortonaItaly

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