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Postablation Endometrial Carcinoma.

Morris Wortman1, George A Vilos2, Angelos G Vilos2

  • 1The Center for Menstrual Disorders, Rochester, New York, USA and Clinical Associate Professor of Obstetrics and Gynecology University of Rochester School of Medicine.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|June 7, 2017
PubMed
Summary
This summary is machine-generated.

Endometrial ablation (EA) may obscure endometrial carcinoma (EC) diagnosis in postmenopausal women. New cases of postablation endometrial carcinoma (PAEC) highlight the need for improved diagnostic strategies and surveillance.

Keywords:
Endometrial ablation complicationsGlobal endometrial ablation complicationsLate-onset endometrial ablation failureReoperative hysteroscopic surgeryUltrasound-guided reoperative hysteroscopy

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Area of Science:

  • Gynecology
  • Oncology
  • Surgical Innovation

Background:

  • Many women have undergone endometrial ablation (EA) in the past 20 years.
  • These women are now in the age group where endometrial carcinoma (EC) is most frequently diagnosed.

Purpose of the Study:

  • To investigate the occurrence and presentation of postablation endometrial carcinoma (PAEC).
  • To evaluate diagnostic modalities and surveillance strategies for PAEC.
  • To explore the role of reoperative hysteroscopic surgery (RHS) and ultrasound in managing PAEC.

Main Methods:

  • Review of Medline and PubMed databases.
  • Introduction of 6 new cases of PAEC, with 4 occurring after global endometrial ablation (GEA).
  • Examination of PAEC presentation, diagnostic efficacy, ablation-to-cancer interval, and stage at diagnosis.

Main Results:

  • Four of the six new PAEC cases occurred after global endometrial ablation (GEA).
  • Concerns exist regarding EA potentially sequestering EC, delaying diagnosis or leading to advanced stages.
  • Traditional diagnostic modalities' efficacy in the presence of EA artifact is debated.

Conclusions:

  • PAEC presents a diagnostic challenge, particularly after GEA.
  • Further research is needed on the impact of EA on EC development and detection.
  • Reoperative hysteroscopic surgery (RHS) and ultrasound surveillance may play roles in diagnosing and screening for PAEC.