[Atypical hyperplasias of the endometrium]

A review of the literature concerning atypical hyperplasias of the endometrium is presented. The new pathological classifications differentiate structural abnormalities from cellular abnormalities. For atypical hyperplasias with cellular abnormalities, similar classifications to that of Richard for the cervix have been proposed: Intra Endometrial Neoplasia (IEN) grades I to III. Evolution of these lesions toward endometrial adenocarcinoma must guide the treatment. In prospective studies, atypical hyperplasias with structural abnormalities evolve into adenocarcinoma in 1.6 to 22 per cent of the cases. In atypical hyperplasia with cellular abnormalities, they evolve into adenocarcinoma in 23 to 57 per cent of the cases, according to the authors. Total hysterectomy is the treatment which is the most suitable for atypical hyperplasias with cellular abnormalities. Continuous progestational medications before menopause and the same given intermittently before menopause, represent the possible medical treatments.