Outpatient hysteroscopy in the diagnosis of neoplastic and preneoplastic lesions of the endometrium.

The results of a study performed on a case series of 250 women treated in our out-patient department for abnormal uterine bleeding are reported. Half of these patients (125) were 45 years of age or over and therefore at risk of adenocarcinoma or endometrial hyperplasia while the other half were under 45 years of age. All the patients were submitted to hysteroscopic examination as out-patients (no important side-effects occurred), together with cytologic and/or histological examination of the endometrium. This procedure revealed no disease in 59 cases (23.6%) and the presence of one or more benign conditions in 188 patients (75.2%) (inflammation, polyposis, myomatosis, endocervical or uterine adenomiosis, endometrial hyperplasias, dysfunctional patterns, intrauterine foreign bodies). Endometrial adenocarcinoma was diagnosed in 3 patients (1.2%). The discovery of 3 cases (1.2%) of adenocarcinomas and 62 cases (24.8%) of endometrial hyperplasias (58 simple glandular hyperplasia, 3 cystic-glandular hyperplasias and 1 polypoid hyperplasia) emphasive the reliability of hysteroscopy in the diagnosis of endometrial neoplasias and their precursors.