Comparison of Frozen and Final Pathology Results in Patients Operated for Endometrial Hyperplasia

Gonca Türker Ergün, Uğurcan Zorlu, Burak Elmas, Bengü Nur Barış Akcan, Gül Kurtaran, Kadir Çetinkaya, Melike Doğanay
In: Gynecology Obstetrics & Reproductive Medicine · 2024 · pp. 1–6 · doi:10.21613/gorm.2023.1493 · W4403380618
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This study evaluated the concordance of frozen and final pathology in endometrial hyperplasia cases, finding that frozen sections missed cancer in 19.3% of atypia cases and that patient age, menopausal status, and endometrial thickness predict malignancy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This retrospective study compared frozen section and final pathology after total abdominal hysterectomy in 144 patients diagnosed preoperatively with endometrial hyperplasia (atypical or non-atypical) from January 2020 to January 2023, evaluating clinical findings, imaging, demographics, and pathology results. For non-atypical hyperplasia, frozen section and final pathology were reported as benign in all cases, while in the atypia group frozen section classified 80.7% as benign and 19.3% as malignant. Final pathology-based benign versus malignant groups differed significantly by age, menopausal status, and average endometrial thickness prior to biopsy. The authors note that when hyperplasia with atypia is present, cancer can appear on final pathology, and they focus on surgical pathology concordance rather than prospective long-term outcomes; this paper does not explicitly discuss endometriosis or adenomyosis, but it was included in the corpus via a keyword match in the upstream search index.

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Abstract

OBJECTIVE: Our study aimed to determine the frequency of endometrial cancer in patients undergoing surgery with a diagnosis of endometrial hyperplasia and to evaluate the concordance between preoperative diagnosis, frozen section examination, and final pathology results. STUDY DESIGN: The clinical findings, imaging results, and all pathology reports of patients who underwent total abdominal hysterectomy for endometrial hyperplasia (atypical or non-atypical) between January 2020 and January 2023 at our hospital were retrospectively evaluated. Demographic and clinical characteristics (age, menopausal status, parity, body mass index, presence of diabetes and hypertension) and pathology results were recorded from patient records. RESULTS: 144 patients diagnosed with endometrial hyperplasia were included in the study. The frozen section and final pathology results of all patients diagnosed with non-atypical endometrial hyperplasia were reported as benign lesions. In the atypia group, the intraoperative frozen section results of 80.7% of the patients were classified as benign lesions, while the results of 19.3% were reported as malignant pathology. A statistically significant difference was found between the benign and malignant lesion groups, which were classified based on the final pathology results, with respect to age, menopausal status, and average endometrial thickness before biopsy. CONCLUSION: In cases of endometrial hyperplasia with atypia, the possibility of cancer appearing in the final pathology results should be taken into consideration. In the preoperative evaluation of patients, characteristics such as endometrial thickness, age, and menopausal status may suggest the likelihood of encountering endometrial cancer during surgery in this patient group.
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Objective

Our study aimed to determine the frequency of endometrial cancer in patients undergoing surgery with a diagnosis of endometrial hyperplasia and to evaluate the concordance between preoperative diagnosis, frozen section examination, and final pathology results. STUDY DESIGN: The clinical findings, imaging results, and all pathology reports of patients who underwent total abdominal hysterectomy for endometrial hyperplasia (atypical or non-atypical) between January 2020 and January 2023 at our hospital were retrospectively evaluated. Demographic and clinical characteristics (age, menopausal status, parity, body mass index, presence of diabetes and hypertension) and pathology results were recorded from patient records.

Results

144 patients diagnosed with endometrial hyperplasia were included in the study. The frozen section and final pathology results of all patients diagnosed with non-atypical endometrial hyperplasia were reported as benign lesions. In the atypia group, the intraoperative frozen section results of 80.7% of the patients were classified as benign lesions, while the results of 19.3% were reported as malignant pathology. A statistically significant difference was found between the benign and malignant lesion groups, which were classified based on the final pathology results, with respect to age, menopausal status, and average endometrial thickness before biopsy.

Conclusion

In cases of endometrial hyperplasia with atypia, the possibility of cancer appearing in the final pathology results should be taken into consideration. In the preoperative evaluation of patients, characteristics such as endometrial thickness, age, and menopausal status may suggest the likelihood of encountering endometrial cancer during surgery in this patient group. Downloads Downloads Published How to Cite Issue Section License Copyright (c) 2024 Gonca Turker Ergun, Ugurcan Zorlu, Burak Elmas, Bengü Nur Baris Akcan, Gul Kurtaran, Kadir Cetinkaya, Melike Doganay This work is licensed under a Creative Commons Attribution 4.0 International License. All the articles published in GORM are licensed with "Creative Commons Attribution 4.0 License (CC BY 4.0)". This license entitles all parties to copy, share and redistribute all the articles, data sets, figures and supplementary files published in this journal in data mining, search engines, web sites, blogs and other digital platforms under the condition of providing references.

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