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Ultrasound showed slightly enlarged anteverted uterus. Should I go for endometrium ablation and biopsy?

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i am 58 years old and based on my transvaginal ultrasound report impression and recommendation, i have slightly enlarged anteverted uterus with thickened and hyperechoic endometrium heterogenous structure, mid anterior wall, consider focal adenomyosis, cannot entirely rule out an endometrial malignancy.
the anterior wall measures 2.18 cm, while the posterior wall measures 3.03 cm. there is an ill defined hyperechogenic heterogenous structure within the mid anterior wall, which appear to be continous with the mid anterior endometrium. color flow mapping shows mimimal vascular flow within. (color score 1) there are several myomas as follows. M1 intramural, left lower anterior, 1.73x1.68x1.32cm; M2-intramural right lateral, 1.04x1.00x0.75 cm, M3-intramural, left lateral, 0.90x0.80x0.72 cm, M4 intramural, 2.04x1.95x1.64 cm and M5 intramural with subserous component. posterofundal, 1.73x1.62x1.21 cm.
endometrium thickness 0.68 cm, the endometrium is thickened and homogenous, the mid anterior portion of the endometrial-myometrial junction appears indistinct and appears continous with the above heterogenous structure.
additional impressions are presence of myomas nodules, small right ovary 2.49cmx1.31x1.36cm, non-visualized left ovary, unremarkable left adnexa.
do i need to undergo endometrium ablation and biopsy immediately?
Posted Fri, 26 Apr 2013 in X-ray, Lab tests and Scans
Answered by Dr. Ganesh Sanap 1 hour later
Hi, welcome and thanks for writing in.
You need not to worry about endometrial cancer. There is no sonographical indication of endometrial cancer. In post menopausal patients endometrial thickness must be more than 0.8 cm. Also it must be associated with bleeding.
In your case both factors are absent. So no need for immediate biopsy or ablation. Rest of fibroids are small so also no need for treatment for it.
If you have any symptoms please let me know then we can further decide line of investigation or management.

Hope I have answered your query. If you have further concern, please let me know.

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