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Complex Endometrial Hyperplasia with Atypia

MedGen UID:
232389
•Concept ID:
C1333138
•
Pathologic Function

Definition

A hyperplasia characterized by excessive proliferation of endometrial cells, resulting in the formation of complex epithelial structures. It is associated with cytologic atypia and an increased risk of endometrial adenocarcinoma. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVComplex Endometrial Hyperplasia with Atypia

Professional guidelines

PubMed

Role of hysteroscopy during conservative management of atypical endometrial hyperplasia and early-stage endometrial cancer in patients who desire pregnancy.
Gil González Y, Pérez Morales ME, Emergi Zhrigen Y, Santana Suárez MA, Pérez Matos C, Nieto Naya MÁ, Ocón Padrón L, Laseca Modrego M, Arencibia Sánchez O, Sánchez Sánchez V, Martín Martínez AI
J Obstet Gynaecol 2022 Nov;42(8):3435-3440. doi: 10.1080/01443615.2022.2152656. PMID: 37017372
The value of MRI in management of endometrial hyperplasia with atypia.
Natarajan P, Vinturache A, Hutson R, Nugent D, Broadhead T
World J Surg Oncol 2020 Feb 10;18(1):34. doi: 10.1186/s12957-020-1811-5. PMID: 32041614Free PMC Article
Use of levonorgestrel-releasing intrauterine system in the prevention and treatment of endometrial hyperplasia.
Ewies AA, Alfhaily F
Obstet Gynecol Surv 2012 Nov;67(11):726-33. doi: 10.1097/OGX.0b013e318273570b. PMID: 23151756

Recent clinical studies

Etiology

Endometrial hyperplasia as a risk factor of endometrial cancer.
Nees LK, Heublein S, Steinmacher S, Juhasz-Böss I, Brucker S, Tempfer CB, Wallwiener M
Arch Gynecol Obstet 2022 Aug;306(2):407-421. Epub 2022 Jan 10 doi: 10.1007/s00404-021-06380-5. PMID: 35001185Free PMC Article
Typical ultrasound features of various endometrial pathologies described using International Endometrial Tumor Analysis (IETA) terminology in women with abnormal uterine bleeding.
Van Den Bosch T, Verbakel JY, Valentin L, Wynants L, De Cock B, Pascual MA, Leone FPG, Sladkevicius P, Alcazar JL, Votino A, Fruscio R, Lanzani C, Van Holsbeke C, Rossi A, Jokubkiene L, Kudla M, Jakab A, Domali E, Epstein E, Van Pachterbeke C, Bourne T, Van Calster B, Timmerman D
Ultrasound Obstet Gynecol 2021 Jan;57(1):164-172. doi: 10.1002/uog.22109. PMID: 32484286
New concepts for an old problem: the diagnosis of endometrial hyperplasia.
Sanderson PA, Critchley HO, Williams AR, Arends MJ, Saunders PT
Hum Reprod Update 2017 Mar 1;23(2):232-254. doi: 10.1093/humupd/dmw042. PMID: 27920066Free PMC Article
Endometrial cancer.
Sorosky JI
Obstet Gynecol 2012 Aug;120(2 Pt 1):383-97. doi: 10.1097/AOG.0b013e3182605bf1. PMID: 22825101
Endometrial hyperplasia.
Mills AM, Longacre TA
Semin Diagn Pathol 2010 Nov;27(4):199-214. doi: 10.1053/j.semdp.2010.09.002. PMID: 21309256

Diagnosis

Typical ultrasound features of various endometrial pathologies described using International Endometrial Tumor Analysis (IETA) terminology in women with abnormal uterine bleeding.
Van Den Bosch T, Verbakel JY, Valentin L, Wynants L, De Cock B, Pascual MA, Leone FPG, Sladkevicius P, Alcazar JL, Votino A, Fruscio R, Lanzani C, Van Holsbeke C, Rossi A, Jokubkiene L, Kudla M, Jakab A, Domali E, Epstein E, Van Pachterbeke C, Bourne T, Van Calster B, Timmerman D
Ultrasound Obstet Gynecol 2021 Jan;57(1):164-172. doi: 10.1002/uog.22109. PMID: 32484286
New concepts for an old problem: the diagnosis of endometrial hyperplasia.
Sanderson PA, Critchley HO, Williams AR, Arends MJ, Saunders PT
Hum Reprod Update 2017 Mar 1;23(2):232-254. doi: 10.1093/humupd/dmw042. PMID: 27920066Free PMC Article
Endometrial cancer.
Sorosky JI
Obstet Gynecol 2012 Aug;120(2 Pt 1):383-97. doi: 10.1097/AOG.0b013e3182605bf1. PMID: 22825101
Endometrial hyperplasia.
Mills AM, Longacre TA
Semin Diagn Pathol 2010 Nov;27(4):199-214. doi: 10.1053/j.semdp.2010.09.002. PMID: 21309256
Abnormal uterine bleeding. Diagnostic considerations, management options.
Kilbourn CL, Richards CS
Postgrad Med 2001 Jan;109(1):137-8, 141-4, 147-50. doi: 10.3810/pgm.2001.01.832. PMID: 11198249

Therapy

Metformin for endometrial hyperplasia.
Shiwani H, Clement NS, Daniels JP, Atiomo W
Cochrane Database Syst Rev 2024 May 2;5(5):CD012214. doi: 10.1002/14651858.CD012214.pub3. PMID: 38695827Free PMC Article
Endometrial hyperplasia as a risk factor of endometrial cancer.
Nees LK, Heublein S, Steinmacher S, Juhasz-Böss I, Brucker S, Tempfer CB, Wallwiener M
Arch Gynecol Obstet 2022 Aug;306(2):407-421. Epub 2022 Jan 10 doi: 10.1007/s00404-021-06380-5. PMID: 35001185Free PMC Article
Metformin for endometrial hyperplasia.
Clement NS, Oliver TR, Shiwani H, Sanner JR, Mulvaney CA, Atiomo W
Cochrane Database Syst Rev 2017 Oct 27;10(10):CD012214. doi: 10.1002/14651858.CD012214.pub2. PMID: 29077194Free PMC Article
Triple negative endometrial cancer.
Bulsa M, Urasińska E
Ginekol Pol 2017;88(4):212-214. doi: 10.5603/GP.a2017.0040. PMID: 28509323
Progestin therapy of complex endometrial hyperplasia with and without atypia.
Reed SD, Voigt LF, Newton KM, Garcia RH, Allison HK, Epplein M, Jordan D, Swisher E, Weiss NS
Obstet Gynecol 2009 Mar;113(3):655-662. doi: 10.1097/AOG.0b013e318198a10a. PMID: 19300331Free PMC Article

Prognosis

The Evolving Spectrum of Endometrial Glandular Proliferations With Corded and Hyalinized Features.
Pors J, Weiel JJ, Ryan E, Longacre TA
Am J Surg Pathol 2023 Sep 1;47(9):1067-1076. Epub 2023 Jul 27 doi: 10.1097/PAS.0000000000002078. PMID: 37493099
Endometrial hyperplasia in asymptomatic subfertile population.
Aldarazi K, Omran H, Jassim NM
J Gynecol Obstet Hum Reprod 2022 Apr;51(4):102337. Epub 2022 Feb 10 doi: 10.1016/j.jogoh.2022.102337. PMID: 35151930
Triple negative endometrial cancer.
Bulsa M, Urasińska E
Ginekol Pol 2017;88(4):212-214. doi: 10.5603/GP.a2017.0040. PMID: 28509323
Endometrial cancer.
Sorosky JI
Obstet Gynecol 2012 Aug;120(2 Pt 1):383-97. doi: 10.1097/AOG.0b013e3182605bf1. PMID: 22825101
Endometrial cancer.
Sorosky JI
Obstet Gynecol 2008 Feb;111(2 Pt 1):436-47. doi: 10.1097/AOG.0b013e318162f690. PMID: 18238985

Clinical prediction guides

Ultrasound features of endometrial pathology in women without abnormal uterine bleeding: results from the International Endometrial Tumor Analysis study (IETA3).
Heremans R, Van Den Bosch T, Valentin L, Wynants L, Pascual MA, Fruscio R, Testa AC, Buonomo F, Guerriero S, Epstein E, Bourne T, Timmerman D, Leone FPG; IETA Consortium
Ultrasound Obstet Gynecol 2022 Aug;60(2):243-255. doi: 10.1002/uog.24910. PMID: 35385178
Endometrial hyperplasia in asymptomatic subfertile population.
Aldarazi K, Omran H, Jassim NM
J Gynecol Obstet Hum Reprod 2022 Apr;51(4):102337. Epub 2022 Feb 10 doi: 10.1016/j.jogoh.2022.102337. PMID: 35151930
Typical ultrasound features of various endometrial pathologies described using International Endometrial Tumor Analysis (IETA) terminology in women with abnormal uterine bleeding.
Van Den Bosch T, Verbakel JY, Valentin L, Wynants L, De Cock B, Pascual MA, Leone FPG, Sladkevicius P, Alcazar JL, Votino A, Fruscio R, Lanzani C, Van Holsbeke C, Rossi A, Jokubkiene L, Kudla M, Jakab A, Domali E, Epstein E, Van Pachterbeke C, Bourne T, Van Calster B, Timmerman D
Ultrasound Obstet Gynecol 2021 Jan;57(1):164-172. doi: 10.1002/uog.22109. PMID: 32484286
Endometrial cancer.
Sorosky JI
Obstet Gynecol 2012 Aug;120(2 Pt 1):383-97. doi: 10.1097/AOG.0b013e3182605bf1. PMID: 22825101
Endometrial cancer.
Sorosky JI
Obstet Gynecol 2008 Feb;111(2 Pt 1):436-47. doi: 10.1097/AOG.0b013e318162f690. PMID: 18238985

Recent systematic reviews

Metformin for endometrial hyperplasia.
Shiwani H, Clement NS, Daniels JP, Atiomo W
Cochrane Database Syst Rev 2024 May 2;5(5):CD012214. doi: 10.1002/14651858.CD012214.pub3. PMID: 38695827Free PMC Article
Endometrial hyperplasia as a risk factor of endometrial cancer.
Nees LK, Heublein S, Steinmacher S, Juhasz-Böss I, Brucker S, Tempfer CB, Wallwiener M
Arch Gynecol Obstet 2022 Aug;306(2):407-421. Epub 2022 Jan 10 doi: 10.1007/s00404-021-06380-5. PMID: 35001185Free PMC Article
Metformin for endometrial hyperplasia.
Clement NS, Oliver TR, Shiwani H, Sanner JR, Mulvaney CA, Atiomo W
Cochrane Database Syst Rev 2017 Oct 27;10(10):CD012214. doi: 10.1002/14651858.CD012214.pub2. PMID: 29077194Free PMC Article
Atypical Endometrial Polyps and Concurrent Endometrial Cancer: A Systematic Review.
de Rijk SR, Steenbergen ME, Nieboer TE, Coppus SF
Obstet Gynecol 2016 Sep;128(3):519-525. doi: 10.1097/AOG.0000000000001566. PMID: 27500332
Efficacy of oral or intrauterine device-delivered progestin in patients with complex endometrial hyperplasia with atypia or early endometrial adenocarcinoma: a meta-analysis and systematic review of the literature.
Baker J, Obermair A, Gebski V, Janda M
Gynecol Oncol 2012 Apr;125(1):263-70. Epub 2011 Dec 3 doi: 10.1016/j.ygyno.2011.11.043. PMID: 22196499

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