Complex hyperplasia of the endometrium. Predictive value of curettage vs. hysterectomy specimens

We reviewed 94 cases of complex endometrial hyperplasia (CH) with and without atypia to assess some of the clinical and pathologic changes observed on curettage and in hysterectomy specimens. Age, parity, height, weight and nomograms did not differ between CH with or without atypia, and CH associated with endometrial carcinoma. CH without atypia, however, predicted lesser degrees of malignancy as compared to CH with atypia. Progesterone or progestinlike treatment is indicated for CH without atypia along with endometrial monitoring, but CH with atypia necessitates diagnostic and therapeutic hysterectomy whenever fertility is not a priority.