Conocer la incidencia de pólipos endometriales malignos en función del estado hormonal, la presencia o no de hemorragia uterina anormal (HUA), el uso de tamoxifeno (TMX) y de terapia hormonal sustitutiva (THS).
Material y métodosSe analizan 1.822 polipectomías histeroscópicas. Tomaban THS 85 pacientes y TMX, 150.
ResultadosLos pólipos de pacientes premenopáusicas presentan más HUA que los de las posmenopáusicas. Se hallaron 16 pólipos histológicamente malignos (0,87%). De éstos, 14 se extirparon a pacientes posmenopáusicas, 11 de ellas presentaban HUA. Entre pacientes premenopáusicas se resecaron 2 pólipos malignos, uno de ellos era asintomático. No se detectaron pólipos malignos entre pacientes con THS. Se encontraron 4 pólipos malignos entre mujeres con tratamiento con TMX, 2 de ellos eran asintomáticos.
ConclusiónLa resección sistemática de los pólipos endometriales permite detectar todos los pólipos malignos, incluso en los casos de pacientes asintomáticas y/o premenopáusicas.
To determine the incidence of malignant endometrial polyps according to hormonal status, the presence of abnormal uterine hemorrhage (AUH), and the use of tamoxifen (TMX) or hormone replacement therapy (HRT).
Material and methodsWe analyzed 1,822 hysteroscopic polypectomies. Eighty-five patients were undergoing HRT and 150 were receiving TMX.
ResultsPolyps in premenopausal patients produced more AUH than those in postmenopausal women. Sixteen histologically malignant polyps were identified (0.87%). Of these, 14 were removed from postmenopausal women, 11 of whom presented AUH. Two malignant polyps were removed from premenopausal women, of which one was asymptomatic. No malignant polyps were found in women undertoing HRT. Four malignant polyps were found in women receiving TMX, one of whom was asymptomatic.
ConclusionSystematic resection of endometrial polyps allows detection of all malignant polyps, even in asymptomatic and/or premenopausal patients.