Nazdar Raouf¹* and Amal Abdulhakeem²

¹Consultant at Duhok Obstetrics and Gynaecology Teaching Hospital, Kurdistan Region, Dohuk city, Iraq
²Specialist at Duhok Obstetrics and Gynaecology Teaching Hospital, Kurdistan Region, Dohuk city, Iraq

*Corresponding Author: Nazdar Raouf, Consultant at Duhok Obstetrics and Gynaecology Teaching Hospital, Kurdistan Region, Dohuk city, Iraq.

Received: July 01, 2025; Published: July 14, 2025

Abstract

Background: Endometrial polyps are localised, hyperplastic growths of stroma and endometrial glands that protrude from the endometrium's surface. Objective: To evaluate the incidence of malignancy in endometrial polyps, in patients undergoing hysteroscopic polypectomy.

Study design: Over the course of five years, from May 2020 to March 2025, a prospective study was carried out at the Duhok Obstetrics and Gynaecology Teaching Hospital in Iraqi Kurdistan.The study included 130 patients with endometrial polyps, hysterscopic polypectomy was carried out, specimens sent to histopathology. Histopathological diagnosis made a distinction between Non-polypoid lesions that were misdiagnosed as polyps and endometrial polyps, which were classified as group A benign lesions and group B precancerous , and neoplastic lesions,

Results: Women's mean age was 46.12 ± 8.0,women's mean body mass index (BMI) was 28.07 ± 5.02.The mean parity was 4.75 ± 2.35.The majority of them (55.3%) had history of one miscarriage. Menopause was present in 76 cases (58.4%).%) . 52 cases (40%) had benign endometrial polyps.Five patients (3.8%) had endometrial polyps with atypical complex hyperplasia, which are precancerous lesions. Neoplastic lesions, which are endometrial polyps with endometrial malignancy were present in two patients (1.5). Women in group B were statistically significantly more likely to have endometrial polyps larger than 1.5 cm, be older, be menopausal, and have a history of chronic hypertension. There was no statistically significant impact from any of the other risk factors

Conclusion: Patients with endometrial polyps should be managed individually, taking into account the patient's age, menopausal status, and the size of the polyp. In menopause all polyps should be removed.

Keywords: Endometrial polyp; Menopause; Hysteroscopy; Malignancy

References

1. Lieng M., et al. “Treatment of endometrial polyps: a systematic review”. Acta Obstetricia et Gynecologica Scandinavica 89 (2010): 992.
2. Lee SC., et al. “The oncogenic potential of endometrial polyps: a systematic review and meta-analysis”. Obstetrics and Gynecology 116 (2010): 1197.
3. Mutter GL., et al. “Endometritis, metaplasias, polyps, and miscellaneous changes”. In: Robboy's Pathology of the Female Reproductie Tract, 2^nd , Robboy SJ, Mutter GL, Prat J, et al (Eds), Churchill Livingston Elsevier, Oxford (2009): 343.
4. Ferrazzi E., et al. “How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study”. American Journal of Obstetrics and Gynecology 200 (2009): 235.e1.
5. Ben-Arie A., et al. “The malignant potential of endometrial polyps”. European Journal of Obstetrics and Gynecology and Reproductive Biology 115 (2004): 206.
6. Salim S., et al. “Diagnosis and management of endometrial polyps: a critical review of the literature”. Journal of Minimally Invasive Gynecology 18 (2011): 569.
7. Nieuwenhuis LL., et al. “Three-dimensional saline infusion sonography compared to two-dimensional saline infusion sonography for the diagnosis of focal intracavitary lesions”. Cochrane Database of Systematic Reviews 5 (2017): CD011126.
8. van Hanegem N., et al. “Diagnostic workup for postmenopausal bleeding: a randomised controlled trial”. BJOG 124 (2017): 231.
9. Chan SS., et al. “A randomised controlled trial of prophylactic levonorgestrel intrauterine system in tamoxifen-treated women”. BJOG 114 (2007): 1510.
10. Pre utthipan S and Herabutya Y. “Hysteroscopic polypectomy in 240 premenopausal and postmenopausal women”. Fertility and Sterility 83 (2005): 705.
11. Gimpelson RJ and Rappold HO. “A comparative study between panoramic hysteroscopy with directed biopsies and dilatation and curettage. A review of 276 cases”. American Journal of Obstetrics and Gynecology 158 (1988): 489.
12. Tanos V., et al. “The management of polyps in female reproductive organs”. International Journal of Surgery 43 (1988): 7-16.
13. Mazur MT and Kurman RJ. “Polyps. In: Mazur MT, Kurman RJ, editors. Diagnosis of endometrial biopsies and curettings. New York: Springer-Verlag (1995): 1-260.
14. Dahjanov I., et al. “Anderson’s pathology. 10th ed. St.Louis: Mosby-Year Book (1996): 2231-309.
15. Anderson MC., et al. “Pathology of the female reproductive tract. London: Churchill Livingstone (2002): 285-303.
16. Yela DA., et al. “Malignancy risk in Braziliawomen with endometrial polyps”. Journal of Gynecologic Surgery 4 (2016): 226-229.
17. Scully RE., et al. “World Health Organization International histologic classification of tumors. Histologic typing of female genital tract tumors. Berlin, Germany: Springer- Verlag (1994).
18. Silva Ega and Jenkins R. “Serous carcinoma in endometrial polyps”. Modern Pathology 3 (1990): 120-128.
19. Kahner S., et al. “Homologous mixed mullerianumours (carcinosarcoma) confined to endometrial polyps”. American Journal of Obstetrics and Gynecology 121 (1975): 278-279.
20. Barwick KW and Livolsi VA. “Heterologous mixed mullerian tumour confined to an endometrial polyp”. Obstetrics and Gynecology 53 (1979): 512-514.
21. Patsner B. “Late recurrence of a uterine clear cell adenocarcinoma confined to an endometrial polyp: case report”. European Journal of Gynaecological Oncology 19 (1998): 522-523.
22. Costa-Paiva L., et al. “Risk of malignancy in endometrial polyps in premenopausal and postmenopausal women according to clinicopathologic characteristics”. Menopause 18 (2011): 1278-1282.
23. Antunes A., et al. “Endometrial polyps in pre- and postmenopausal women: factors associated with malignancy”. Maturitas 57 (2007): 415-421.
24. Savelli L., et al. “Histopathologic features and risk factors for benignity, hyperplasia and cancer in endometrial polyps”. American Journal of Obstetrics and Gynecology 188 (2003): 927-931.
25. DeWaay DJ., et al. “Natural history of uterine polyps and leiomyoma”. Obstetrics and Gynecology 100 (2002): 3-9.

Citation

Citation: Nazdar Raouf and Amal Abdulhakeem. “Evaluation of the Malignant Risk of Endometrial Polyps". Acta Scientific Women's Health 7.7 (2025): 41-46.

Copyright

Copyright: © 2025 Nazdar Raouf and Amal Abdulhakeem. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.