DISCUSSIONS Hysteroscopy was done on the patient to diagnose her condition and also to take the biopsy of her endometrium. Will it cause the tumor to get spread even more during the procedure? Or is there any better option than that? First, the diagnosis should depend on the patient’s presenting complaint, symptoms, signs, and also the risk factors associated with them. In this case, she presented with postmenopausal bleeding, which endometrial carcinoma become the main differential diagnosis until it is proven otherwise. The main onus is to exclude carcinoma of the endometrium or cervix and premalignant endometrial hyperplasia with cytological atypia, which account for about 20% of cases.1 This then bring us to the question on how do we differentiate and stage the disease. Endometrial hyperplasia involves the proliferation of endometrial glands that results in a greater than normal gland-to-stromal ratio.2 This will cause the endometrial wall to be thicker but it is important to tell the …show more content…
But it should always be preceded with pelvic examination and transvaginal ultrasound (TVS) that raised the suspicion of carcinoma first. Hysteroscopy may be necessary if abnormal bleeding persists or if intrauterine abnormalities are detected on TVS or previous endometrial biopsy.6 Beside dilation and curettage that is done along with hysteroscopy, endometrial biopsy can also be taken by doing Pipelle biopsy. From the study that comparing the two endometrial biopsy, it shows that hysteroscopy in patients with endometrial carcinoma is not associated with poorer outcomes, as would be evidenced by more advanced stages of diseases or higher mortality rates. 7 So, we can say that the patient in this case does not carry higher risk of developing more severe stages of carcinoma by doing the hysteroscopy