Endometrial carcinoma arising within extensive intrauterine synechiae

In patients with intrauterine adhesions severe enough to produce amenorrhoea, biologically active endometrium can undergo malignant change. To our knowledge, this is the first reported case of endometrial carcinoma arising within intrauterine synechiae. A 71-year-old woman receiving unopposed estrogen developed post-menopausal bleeding. At endovaginal sonography we detected a polypoid mass. Extensive intrauterine synechiae within the uterus were noted during hysteroscopy, and a polypoid lesion was seen adjacent to a synechia. Biopsy demonstrated endometrial adenocarcinoma arising from a synechia. Hysterectomy and bilateral salpingo-oophorectomy were performed. A well-differentiated adenocarcinoma of the endometrium was demonstrated. Asherman syndrome and endometrial adenocarcinoma can exist simultaneously. In such cases, hysteroscopy is essential for diagnosis of synechiae and for target biopsy.