Hysteroscopic Appearance of Benign and Malignant Endometrial Polyps. What are the Differences?

The objective of this study is to evaluate the differences between benign and malignant endometrial polyps at hysteroscopy. In our collected experience of 1793 diagnostic hysteroscopies performed from December 1989 to December 1993, we found 3 malignant polyps in 151 cases of hysteroscopically diagnosed endometrial polyps. The differences in appearance of the malignant polyps are mainly represented by surface irregularities such as necrosis, vascular irregularities and whitish thickened areas. We conclude that when these patterns are present it is better to perform a targeted biopsy to confirm the hysteroscopic diagnosis. This approach allows selection of patients that can be treated by hysteroscopic polypectomy from those who require more radical treatment.