An Atypical Sonographic Presentation of an Endometrial Polyp in a Postmenopausal Woman: A Case Report

Endometrial polyps, a common gynecological finding, may be symptomatic or asymptomatic, with age and postmenopausal bleeding identified as significant risk factors. While typically identifiable on ultrasound, atypical presentations can pose diagnostic challenges. We report a case of a postmenopausal woman initially misdiagnosed with endometrial cavity fluid due to the polyp's almost entirely cystic appearance on ultrasound. Hysteroscopy revealed hyperplastic endometrium with a 3.5-cm endometrial polyp. A polypectomy was performed, and the specimen was sent for histopathological evaluation, which revealed an endometrial polyp and cystic hyperplasia without atypia. This case highlights the importance of considering atypical sonographic presentations of endometrial polyps, particularly in postmenopausal women, to avoid diagnostic delays and guide appropriate management.