The precise mechanism of formation of endometrial polyps is unclear, although it appears to represent simple endometrial growth into pedunculated masses. They most commonly occur in reproductive-aged women, and incidence increases with age. Tamoxifen, obesity, and postmenopausal hormone therapy are associated with increased rates of endometrial polyps.
The incidence of endometrial polyps is difficult to determine as polyps may be asymptomatic, but pathologic examination of post-hysterectomy uteri reveal a prevalence of 10%-24%.
Polyps are most commonly diagnosed during the work-up of AUB, although they may also be discovered incidentally by ultrasound, during surgery involving the uterine cavity (eg, hysteroscopy, cesarean section), or occasionally during pelvic exam if the polyp is protruding through the cervix.
Although endometrial polyps are generally benign (less than 5% are malignant although some are hyperplastic [precancerous]), they do warrant removal both to rule out malignancy and to treat symptoms. Pathologic evaluation is especially recommended in women with an increased risk of endometrial cancer (eg, postmenopausal status, obesity, tamoxifen exposure). Risk of hyperplasia or malignancy increases significantly when the patient is postmenopausal.
N84.0 – Polyp of corpus uteri
11314008 – Polyp of corpus uteri
Differential Diagnosis & Pitfalls
- Endometrial cancer – Should always be considered in cases of AUB.
- Uterine fibroids – Another common cause of AUB; small intracavitary fibroids may be difficult to distinguish from polyps on ultrasound.
- Cervical polyp – May be difficult to distinguish from endometrial polyps if the polyp is protruding through the cervix.
Drug Reaction Data