Background: The optimal management of intrauterine fluid accumulation in postmenopausal women with cervical stenosis is currently debatable. Diagnostic challenge still remains, because of the low accuracy of sonographic histologic prediction. Case: In the case described, an asymptomatic postmenopausal woman was found to have an echogenic endometrial fluid collection on pelvic ultrasound, suspicious for uterine malignancy. Results: After a failed attempt at endometrial sampling secondary to cervical stenosis, the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. The fluid-filled endometrial cavity was found to have extensive benign squamous differentiation. Conclusions: Extensive endometrial squamous metaplasia should be considered as a rare differential diagnosis when postmenopausal women are found to have echogenic intrauterine fluid collections on ultrasound. (J GYNECOL SURG 29:148)
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References
1.
CarlsonJA, ArgerP, ThompsonS, CarlsonEJ. Clinical and pathologic correlation of endometrial cavity fluid detected by ultrasound in the postmenopausal patient. Obstet Gynecol, 1991; 77:119.
2.
TakacsP, De SantisT, NicholasMC, VermaU, StrassbergR, DuthelyL. Echogenic endometrial fluid collection in postmenopausal women is a significant risk factor for disease. J Ultrasound Med, 2005; 24:1477.
3.
GullB, KarlssonB, WiklandM, MilsomI, GranbergS. Factors influencing the presence of uterine cavity fluid in a random sample of asymptomatic postmenopausal women. Acta Obstet Gynecol Scand, 1998; 77:751.
4.
BreckenridgeJW, KurtzAB, RitchieWGM, MachtEL. Postmenopausal uterine fluid collection: Indicator of carcinoma. Am J Radiol, 1982; 139:529.
5.
GoldsteinSR. Postmenopausal endometrial fluid collections revisited: look at the doughnut rather than the hole. Obstet Gynecol, 1994; 83:738.
6.
BewtraC, XieQM, HunterW, JergensenW. Icthyosis uteri: a case report and review of literature. Arch. Pathol Lab. Med, 2005; 129:124.
7.
KinjoT, KamiyamaK, ChinenK, IwamasaT, KuriharaK, HamadaT. Squamous metaplasia induced by transfection of human papillomavirus DNA into cultured adenocarcinoma cells. Mol Pathol, 2003; 56:97.
8.
BaggaPK, JaswalTS, DattaU, MahajanNC. Primary endometrial squamous cell carcinoma with extensive squamous metaplasia and dysplasia. Indian Journal of Pathology and Microbiology, 2008; 51:267.
