Hysteroscopy in the diagnosis of endometrial carcinoma: case report

The incidence of endometrial carcinoma is particularly high in postmenopausal women. Screening techniques are not yet satisfactory. Postmenopausal anatomic physiologic changes in the genitalia may prevent visualization and exploration of the uterine cervix. A case report is presented of an 87-year-old woman with a 6-month history of genital bleeding. Severe vaginal stenosis prevented diagnostic curettage, even under adequate anesthesia. To perform the indicated hysteroscopy, a panendoscope had to be employed for direct visualization of the cervix and uterine cavity. Selective biopsy specimens revealed endometrial adenocarcinoma. The hysteroscopy technique is easy to learn. However, if the patient's physician has not acquired this experience, a urologist, who must necessarily use endoscopy extensively, can be of great help in the evaluation fo gynecologic patients with uterine problems similar to those described in this report.