Risks and usefulness of sonohysterography in patients with endometrial carcinoma

The purposes of this study were to assess the risk of malignant cell dissemination into the peritoneal cavity through the fallopian tubes in patients with endometrial carcinoma undergoing sonohysterography and to evaluate the accuracy of sonohysterography in the estimation of myometrial invasion by the tumor and its role in the preoperative staging.

This was a prospective study that was conducted at the Sassari University hospital. Thirty-two patients with endometrial carcinoma underwent sonohysterography during laparotomy for hysterectomy. The fluid that spilled from the fallopian tubes and was collected into graduated plastic tubes was analyzed by a pathologist. The presence of malignant endometrial cells in the fluid that was spilled from the fallopian tubes was assessed. The depth of myometrial invasion by tumor was assessed by gross and sonohysterographic examinations and compared with histopathologic findings.

Malignant cells were reported in the fluid that spilled from the fallopian tubes in 2 patients (6.25%). The occurrence of suspected cells in the fallopian fluid was reported in 6 women (18.75%); thus, the presence of malignant or suspicious cells in the fluid that spilled from the fallopian tubes was reported in 8 of 32 cases (25%). Sonohysterography correctly evaluated the depth of myometrial invasion in 27 of 32 cases (84.37%).

Sonohysterography was useful to assess the depth of myometrial invasion and may have a role in preoperative staging, but sonohysterography should not be performed in women with suspicious diagnosis of endometrial carcinoma.