Abstract
Malignant and Pseudomalignant Hyperplasia of the Endometrium in Postmenopausal Women treated with Oestrogens.
In a two year period 81 patients were admitted because of metrorrhagia related to postmenopausel oestrogen treatment. Diagnostic curettage disclosed various degree of oestrogenic stimulation of the endometrium from slightly proliferative to cyclic glandular hyperplasia, which was observed in no less than 29 cases.
The causal treatment was in the majority of cases repeated injections of oestradiolbenzoate or continuous intake of oestrogen tablets.
In 5 cases the histological diagnosis was endometrial hyperplasia suspect for malignancy. After a period of observation of 6 weeks without oestrogens a new curettage was done. in 3 of the cases the diagnosis of malignant hyperplasia was maintained and a subsequent hysterectomy substantiaited the diagnose of endometrial carcinoma. in 2 cases an atrophic climacteric pattern of the endometrium was found at the second curettage. These pseudomalignant cases have been followed now for up to three years without any signs of uterine malignancy.
Two malignant cases and one pseudomalignant case are reported in detail with the relevant microphotos. It is not possible morphologically to discriminate malignant from pseudomalignant hyperplasia. a period of observation without oestrogens before the final diagnostic curettage is necessary for this differential diagnosis.