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ADENOCARCINOMA DIAGNOSED AT ENDOMETRIAL ABLATION

Steed, Helen L. MD; Scott, Josef Z. MB, ChB, FRCSC

CASE REPORTS
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Background Endometrial ablation is a surgical alternative to hysterectomy. Cases exist in the literature of endometrial adenocarcinoma found at endometrial ablation. If endometrial cancer is occultit might not be detected during ablation, especially if destructive techniques are used.

Case A 41-year-old woman had a history of menorrhagia. A previous D&C showed benign proliferative endometrium. Investigations for menorrhagia found no abnormalities. The diagnosis was dysfunctional uterine bleeding. Endometrial ablation was done and the pathologic examination of the resected endometrium found focal, well-differentiated adenocarcinoma of the endometrium.

Conclusion This case shows the importance of patient selection, evaluation, and surveillance after endometrial ablation. Resection of the endometrium is superior to destructive techniques because it provides tissue for pathologic evaluation. We recommend close postoperative surveillance in such cases.

Although endometrial ablation is an effective treatment of dysfunctional bleeding, the possibility of occult adenocarcinoma must be considered.

Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.

Address reprint requests to: Helen L. Steed, MD Department of Obstetrics and Gynecology University of Alberta CSC, Royal Alexandra Site, 10240 Kingsway Avenue Edmonton, Alberta T5H 3V9, Canada. E-mail: ssteed@compusmart.ab.ca

Received July 27, 2000. Received in revised form October 10, 2000. Accepted October 26, 2000.

© 2001 The American College of Obstetricians and Gynecologists