Endometrial proliferative lesions associated with uterine fibromatosis

Hysteroscopy and uterine curettage are required in cases of atypical hyperplasia in premenopause and in all cases of hyperplasia with/without atypia in postmenopausal women. Biopsic curettage is the method of choice in the diagnosis of endometrial pathology. Transvaginal ultrasound and Doppler examination are useful in assessing the risk of endometrial hyperplasia or endometrial cancer in postmenopausal women without/with continuous replacement therapy, but cannot replace endometrial biopsy to exclude endometrial cancer diagnosis. Medical treatment with progesterone containing drugs addresses endometrial hyperplasia without atypia. Surgical treatment is recommended for premenopausal and postmenopausal patients with uterine fibromatosis associated with atypical hyperplasia as well as patients with adenocarcinoma. Risk of progression to malignancy requires clinical and histopathological monitoring to avoid insufficient treatment of lesions with evolutive risk and aggressive treatment of lesions without risk.