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What do my ultrasound test results indicate?

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Posted on Fri, 6 May 2016
Question: Hi my name is XXXX and I'm 52years old. I haven't had a period for 2 years. Recently I had a pelvic ultrasound as I have had some pelvic pain. The ultrasound showed an enlarged multifibroid uterus with lobulation of the uterine outline. Endometrial thickening measuring 11mm with small cystic structures.
At ultrasound it is not possible to differentiate cystic endometrial hyperplasia for endometrial neoplasia.
I have diabetes type 11 and hypertension. I have to see a GYN but just wondering what you think will happen. Thankyou
doctor
Answered by Dr. Nishikant Shrotri (31 minutes later)
Brief Answer:
Hysteromicroscopically guided endometrial biopsy is indicated

Detailed Answer:
Dear XXXXXXX ,

At the age of 52 you have missed your period for 2 years. This indicates that you are in the postmenopausal phase of your life.

Your ultrasound has shown multiple fibroids in the uterus. As expected the endometrium is also thick. Since both these conditions are dependant on or associated with a status called as hyperoestrinism (high oestrogen in the body), many a times they go hand in hand. However, 11 mm thick endometrium is worth causing a concern. Your thorough work up to rule out endometrial cancer is required. About 30 % of Fibroid uterus cases have coexistent endometrial cancer.

Usually the differentiation of cystic endometrial hyperplasia (benign hyperplasia) and endometrial neoplasia cannot be done by ultrasonography appropriately and needs microscopic study of the suspicious endometrial sample. Hysteroscopy or Hysteromicroscopy with guided endometrial biopsy of suspicious endometrial tissue helps the diagnosis.

Yes, history of Diabetes does endorse the demand for endometrial study. Moreover, please keep your sugar in control

For making me more equipped to understand your status, would you please furnish me with the following information:
1. When did you have menopause?
2. What is your Obstetric history? - Marital and pregnancies?
3. Did you any time have irregular bleeding after menopause?
4. Is there any history of Genital tract malignancy in your family?
5. Will you please update me with your sugar levels and HbA levels?
6. Do you regularly carry our self examination of the breasts? What are your findings?

Please keep me informed about these facts and upload the images and reports of your scan for me to review. Then if needed, I might suggest you some more investigations. Meanwhile, I would suggest you to undergo Hysteromicroscopy and guided endometrial biopsy to find about the uterine cavity and status & underlying cause of endometrial thickness.

If you want any more information or guidance from my side, please feel free to ask me, XXXXXXX

Dr. Nishikant Shrotri

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Nishikant Shrotri (5 hours later)
Thanks very much Dr Shrotri for the information you gave to me.
To answer your questions, I went through menopause two years ago.
I am not married and never had any pregnancies.
I had a little bit of bleeding about 6 months ago but only slight.
My grandmother died of uterine cancer at 84 years of age.
My sugar levels are well controlled 5.8 today.
I do regularly carry out self examination of my breasts, with no
problems so far. Had a mammogram 9 months ago, all normal
doctor
Answered by Dr. Nishikant Shrotri (3 hours later)
Brief Answer:
High risk case; needs thorough investigations without delay

Detailed Answer:
Dear XXXXXXX

You have indeed provided me very relevant and important information.

Considering family history of uterine cancer to your mother, you fall in the high risk group for endometrial cancer. Moreover, the women without any children have further more risk of Fibroids and Endometrial cancer. You already have Fibroids. I had informed you in my last communication that there is 30% coexistence of endometrial cancer with fibroids.

Hence thorough investigations are required for finding out the cause of endometrial thickening. I have already informed you about the required investigations in my initial message. My advice would be to submit yourself for these investigations and Hysteroscopy without delay.

I would appreciate if you can upload the images and reports of previous scans and the further investigations too. With the help of them, we can continue our further discussion so that I can advise you further.

For any more information or advice, I am always available to you, XXXXXXX You may consider posting a favourable review with 5 stars rating for me, if you feel so.

DR. Nishikant Shrotri
Above answer was peer-reviewed by : Dr. Naveen Kumar
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Dr. Nishikant Shrotri

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What do my ultrasound test results indicate?

Brief Answer: Hysteromicroscopically guided endometrial biopsy is indicated Detailed Answer: Dear XXXXXXX , At the age of 52 you have missed your period for 2 years. This indicates that you are in the postmenopausal phase of your life. Your ultrasound has shown multiple fibroids in the uterus. As expected the endometrium is also thick. Since both these conditions are dependant on or associated with a status called as hyperoestrinism (high oestrogen in the body), many a times they go hand in hand. However, 11 mm thick endometrium is worth causing a concern. Your thorough work up to rule out endometrial cancer is required. About 30 % of Fibroid uterus cases have coexistent endometrial cancer. Usually the differentiation of cystic endometrial hyperplasia (benign hyperplasia) and endometrial neoplasia cannot be done by ultrasonography appropriately and needs microscopic study of the suspicious endometrial sample. Hysteroscopy or Hysteromicroscopy with guided endometrial biopsy of suspicious endometrial tissue helps the diagnosis. Yes, history of Diabetes does endorse the demand for endometrial study. Moreover, please keep your sugar in control For making me more equipped to understand your status, would you please furnish me with the following information: 1. When did you have menopause? 2. What is your Obstetric history? - Marital and pregnancies? 3. Did you any time have irregular bleeding after menopause? 4. Is there any history of Genital tract malignancy in your family? 5. Will you please update me with your sugar levels and HbA levels? 6. Do you regularly carry our self examination of the breasts? What are your findings? Please keep me informed about these facts and upload the images and reports of your scan for me to review. Then if needed, I might suggest you some more investigations. Meanwhile, I would suggest you to undergo Hysteromicroscopy and guided endometrial biopsy to find about the uterine cavity and status & underlying cause of endometrial thickness. If you want any more information or guidance from my side, please feel free to ask me, XXXXXXX Dr. Nishikant Shrotri