Surgical Intervention of Huge Uterine Polyp and its Oncogenic Potential and Clinical Implications

Endometrial polyps are common benign growths; however, exceptionally large polyps are rare and may present with severe clinical symptoms. Surgical intervention is often necessary to manage complications, and histopathological evaluation is crucial to assess their oncogenic potential. Accordingly, the aim of this study is to evaluate the clinical presentation, surgical management, and oncogenic potential of unusually large uterine polyps to emphasize the importance of early diagnosis and timely intervention.

This retrospective study analyzed data from 200 patients undergoing hysteroscopic polypectomy for uterine polyps exceeding 3 cm in size. Preoperative assessments included ultrasonography, hysteroscopy, and histopathological evaluation. Surgical outcomes, histopathological findings, and postsurgical follow-up data over 2 years were documented.

Among the 200 patients examined, three cases were identified with unusually large endometrial polyps, each presenting with severe clinical symptoms. Case 1 involved a 35-year-old woman with severe suprapubic pain, anemia, and a protruding vaginal mass. Magnetic resonance imaging (MRI) revealed an 8.49 cm posterior endometrial polyp extending to the posterior cervical wall. Case 2 was a 32-year-old woman with urinary difficulty, menorrhagia, and anemia. MRI identified two uterine polyps, the largest measuring 11.45 cm × 6.1 cm, extending up to the cervix. Case 3 was a 43-year-old woman with urinary retention, continuous vaginal bleeding, and a massive 21.4 cm × 8.65 cm × 8.0 cm polyp originating from the fundal region. Hysterectomy was performed in all cases, and histopathological evaluation confirmed benign polyps without malignancy.

The occurrence of massive uterine polyps is rare but can lead to severe symptoms and significant morbidity. While histopathology confirmed benign pathology in these cases, the potential for malignant transformation underscores the need for early diagnosis and timely surgical intervention. MRI plays a crucial role in preoperative assessment, and hysterectomy remains the definitive treatment for large polyps causing severe clinical symptoms.