Ultrasound scan shows a gestational sac in uterus. Should I be worried about the thickness of uterus?
ENDOMETRIAL HYPERPLASIA ( CYSTIC ) SEEMS LIKELY
Thanks for your query.
Pregnancy has been ruled out in your case definitely by urine and blood tests, so that is out of the way.
An endometrial thickness of 20 mm is most definitely worrisome, especially at your age, which can be considered perimenopausal.
The echogenic thing looking like a gestational sac COULD BE cystic endometrial hyperplasia.
This is a condition where the lining of the uterus overgrows ( due to hormonal imbalance, again common at this age, more common in women who are overweight, are diabetic or have a history of polycystic ovaries ) - and multiple swiss cheese like spaces are found in the overgrown endometrium.
This COULD resemble a gestational sac.
Another possibility is adenomyosis , thickening of the wall of the uterus, which frequently goes hand in hand with endometrial hyperplasia, thickening of the lining of the uterus, which you are having.
Both of these conditions need not worry you.
Your specialist will most probably recommend the next step as a D and C or endometrial biopsy.
The thickened lining is curetted or biopsied and looked into for any remote risk of malignancy.
The condition then is easily treatable with hormones ( progesterone for example ).
So please do not worry.
Also let me know if the ultrasound was done vaginally, as abdominal scans are less reliable, and do not give proper details or visualization.
All the best.
Please feel free to ask for further clarifications.
I am sure that it will turn out to be one of the two - endometrial hyperplasia or adenomyosis.
Do not worry at all as I can see no possibility of a cancer.
However, if it is INDEED endometrial hyperplasia, then a biopsy would further reassure you.
Do not unnecessary worry yourself or look up the subject too much, as right now , you dont even have a diagnosis in hand.
Please do get back after your appointment.
Take care, and wish you luck.
RISK OF MALIGNANCY < 4 %
The incidence of malignant or pre-malignant findings in endometrial polyps ranges from 0.5 to 4.8% in the general population and from 2 to 10% in menopausal women.
I would put your risk of having a malignant change in the polyp at less than 4 %, and this is maximum, in actuality the chance of a polyp being malignant is very less.
Malignancy is more common in postmenopausal women.
Only removal and biopsy will quantify the risk as certain types of polyps ( classified on biopsy ) have higher risk of malignant transformation.
Size of the polyp has no corelation with malignancies, while presence of diabetes, obesity are considered risk factors with increased association .
Just get it removed and wait for the biopsy results.
All said and done, there is more than a 95 % chance , that it is just benign!
I wish you loads of luck and good health always.
See, basically a polyp is an overgrowth of the endometrial lining.
It IS a kind of endometrial hyperplasia ( I should have separately mentioned polyp as an independent condition in the first place ) - however it is an overgrowth of the endometrium itself.
Almost one third of endometrial polyps are also associated with endometrial hyperplasia alongside .
This would be revealed when the polyp is removed, and if hyperplasia is also found, then it would be biopsied too.
You do have borderline hypertension, which is not at all a risk factor for developing malignancy.
All the best.
I am almost 99 % sure that the polyp would be benign.
Do get back once the procedure is done and your reports are in hand.
Will be praying for you.
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