The significance of recurrence in endometrial polyps: a clinicopathologic analysis

A subset of endometrial polyps recurs after resection. The clinicopathologic significance of the phenomenon is evaluated herein. Consecutive cases of recurrent polyps (index polyp removed by hysteroscopy-directed polypectomy or by curettage; at least one more polyp diagnosed ≤12 months after) were compared with an age-matched control group of nonrecurrent polyps regarding 15 clinicopathologic features. A total of 107 (5.6%) of the 1908 polyps diagnosed in a sampling specimen during the study period was a recurrence, and 102 (6.9%) of the 1478 patients who were diagnosed with an endometrial polyp in a sampling specimen had at least 1 recurrence. Eighty-six percent of patients with any recurrences had only one recurrence, with a mean duration between the index polyp and the first recurrence of 4.36 months. On univariate analyses, the recurrent polyps were, compared with controls, significantly larger, had a higher stromal mitotic index, and more frequently displayed prominent thick-walled vessels in most fragments of the polyp. However, on Cox regression multivariate analyses, no single clinicopathologic feature was significantly associated with a recurrence. No malignancies were diagnosed during the follow-up of the study and control group patients at median follow-up durations of 23 and 34 months, respectively. In conclusion, the recurrence of an endometrial polyp is relatively uncommon (5.6% of polyps) and does not portend an increased risk of malignancy. We could not identify any clinicopathologic features that conclusively predict a recurrence.