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Complex endometrial hyperplasia without atypia

MedGen UID:
232390
•Concept ID:
C1333139
•
Pathologic Function
Synonym: Complex Endometrial Hyperplasia without Atypia
SNOMED CT: Complex endometrial hyperplasia without atypia (10738291000119106)

Definition

A hyperplasia characterized by excessive proliferation of endometrial cells, resulting in the formation of complex epithelial structures. Epithelial atypia is absent. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVComplex endometrial hyperplasia without atypia

Professional guidelines

PubMed

The levonorgestrel intrauterine system is an effective treatment in selected obese women with abnormal uterine bleeding.
Vilos GA, Marks J, Tureanu V, Abu-Rafea B, Vilos AG
J Minim Invasive Gynecol 2011 Jan-Feb;18(1):75-80. doi: 10.1016/j.jmig.2010.09.013. PMID: 21195957
Cytological criteria of endometrial lesions with emphasis on stromal and epithelial cell clusters: result of 8 years of experience with intrauterine sampling.
Kobayashi H, Otsuki Y, Simizu S, Yamada M, Mukai R, Sawaki Y, Nakayama S, Torii Y
Cytopathology 2008 Feb;19(1):19-27. Epub 2007 Oct 3 doi: 10.1111/j.1365-2303.2007.00493.x. PMID: 17916089

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 hyperplasia.
Mills AM, Longacre TA
Semin Diagn Pathol 2010 Nov;27(4):199-214. doi: 10.1053/j.semdp.2010.09.002. PMID: 21309256
Well-differentiated villoglandular adenocarcinoma of the uterine cervix: a clinicopathological study of 24 cases.
Jones MW, Silverberg SG, Kurman RJ
Int J Gynecol Pathol 1993 Jan;12(1):1-7. doi: 10.1097/00004347-199301000-00001. PMID: 8418074

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
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
Well-differentiated villoglandular adenocarcinoma of the uterine cervix: a clinicopathological study of 24 cases.
Jones MW, Silverberg SG, Kurman RJ
Int J Gynecol Pathol 1993 Jan;12(1):1-7. doi: 10.1097/00004347-199301000-00001. PMID: 8418074
The differential diagnosis of endometrial adenocarcinoma. Some viewpoints concerning a common diagnostic problem.
Hendrickson MR, Kempson RL
Pathology 1980 Jan;12(1):35-61. doi: 10.3109/00313028009060053. PMID: 6990356

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
Well-differentiated villoglandular adenocarcinoma of the uterine cervix: a clinicopathological study of 24 cases.
Jones MW, Silverberg SG, Kurman RJ
Int J Gynecol Pathol 1993 Jan;12(1):1-7. doi: 10.1097/00004347-199301000-00001. PMID: 8418074

Prognosis

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
Management of endometrial precancers.
Trimble CL, Method M, Leitao M, Lu K, Ioffe O, Hampton M, Higgins R, Zaino R, Mutter GL; Society of Gynecologic Oncology Clinical Practice Committee
Obstet Gynecol 2012 Nov;120(5):1160-75. doi: 10.1097/aog.0b013e31826bb121. PMID: 23090535Free PMC Article
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

A Large Ovarian Endometrioma Occupying the Abdominal Cavity in a Postmenopausal Patient: A Case Report.
Zografou MT, Naem A, Laganà AS, Krentel H
Medicina (Kaunas) 2023 Jul 30;59(8) doi: 10.3390/medicina59081398. PMID: 37629688Free PMC Article
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
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
Levonorgestrel-releasing intrauterine system for endometrial hyperplasia.
Mittermeier T, Farrant C, Wise MR
Cochrane Database Syst Rev 2020 Sep 6;9(9):CD012658. doi: 10.1002/14651858.CD012658.pub2. PMID: 32909630Free 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

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