What is the ideal treatment for a 55 years female with Simple Hyperplasia of endometrium with Atypia ?
Ans. is a i.e. Simple hysterectomy Management of Atypical Endometrial Hyperplasia : nyszorectomy is the best treatment fot rromer at any age with atypical endometrial hyperplasia because the risk of concurrent subclinical invasive disease is high." "In presence of atypia, response to progesterone therapy is poor and relapse rate is high. Nearly one third of them will progress to cancer and one fouh may already have associated undiagnosed cancer. In women approaching or past menopause, hysterectomy is a safer choice in those with complex or atypical hyperplasia So Remember : Best management of atypical hyperplasia is hysterectomy. Also Know Management of Endometrial Hyperplasia ? - Depends on the patient's age and the presence or absence of cytological atypical. Non atypical hyperplasia : Premenopausal women : Progesterone therapy- options - Medroxyprogesterone acetate for 21 days a month daily for 3 months. - Progesterone containing IUCD. Post menopausal women Simple hyperplasia without atypia - Generally followed without therapy. Complex hyperplasia without atypia - Cyclical / continous progesterone therapy. These patients should be followed annually by endometrial biopsy. Atypical hyperplasia : Post menopasual and premenopausal women not willing to preserve feility- Hysterectomy. Premenopausal women willing to preserve feility - High dose progesterone therapy. Resolution of the hyperplasia must be confirmed by serial endometrial biopsy every 3 months until response is documented, otherwise hysterectomy should be done.
Simple hysterectomy
Medroxy progesterone Acetate (MPA)
Levonorgesterol (LNG)
IUCD