Malignant uterine polyps: types, symptoms and treatments

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Uterine or endometrial polyps in women are protrusions of tissue or tumors that form in the uterine cavity due to the abnormal growth of their inner layer: the endometrium.

In general, the vast majority of uterine polyps are benign. However, about 5% can become malignant.

Both the size of the polyps and their symptoms are very variable among women. In addition, its removal is necessary to avoid the risk of cancer.

Below you have an index with all the points that we will discuss in this article.

Index

Malignant uterine polyps: types, symptoms and treatments

Types of polyps

Uterine polyps are formed due to endometrial hyperplasia, that is, the overgrowth of the endometrial cells. A part of it proliferates independently and does not come off when menstruation takes place. Next, this part of the endometrium stays in the uterus and continues to grow.

The main cause of this abnormal growth and formation of a polyp is a hormonal alteration, specifically by the increase of estrogen.

Regarding the types of endometrial polyps, we can find the following:

Functional uterine polyps are dependent on the female hormones estrogen and progesterone and are always benign. Organic uterine polyps do not have hormone dependence and in 1% of cases are malignant.

Organic polyps are more frequent after menopause and should always be eliminated, both in the case of symptoms such as bleeding and as asymptomatic.

Location of endometrial polyps

Causes

In general, the causes that originate the formation of polyps are unknown, although there are some risk factors such as age or obesity.

Regarding malignant polyps, we have already mentioned that its frequency is higher in women aged 40-65 years who have already entered perimenopause or who are postmenopausal.

Malignant polyps are very infrequent in women of childbearing age.

In women undergoing treatment with tamoxifen for breast cancer, the likelihood of malignant polyps also increases and, therefore, gynecological examinations of these women should be more frequent.

symptom

Most endometrial polyps are asymptomatic and are diagnosed in routine gynecological examinations.

However, malignant polyps usually have a larger size than benign polyps and symptoms such as the following:

  • Hypermenorrhea: bleeding more abundant than normal during menstruation
  • Metrorrhagia: intermenstrual bleeding
  • Vaginal bleeding after menopause
  • Anemia
  • Bleeding after sex if the polyp is found in the cervix
  • Leukorrhea: more abundant vaginal discharge of white or yellow color

To a lesser extent and depending on their size, uterine polyps can cause fertility problems since any obstacle in the uterus makes implantation of the embryo difficult.

Treatments

Polyps of the functional type are not malignant and may disappear spontaneously if they are small.

On the other hand, if the polyps produce symptoms or are of the organic type, they should be removed as they could become malignant over time.

The operation for the removal of polyps is a simple intervention called polypectomy. It consists of doing a hysteroscopy through the vagina, which allows at the same time to identify and remove the polyp with special tweezers or a handle.

Treatment of polyps: polypectomy

In women with menopause, a 10% relationship has been found between uterine polyps and endometrial carcinoma. Therefore, resection and subsequent pathological biopsy will be mandatory to check if they were benign or malignant polyps.

In general, all uterine polyps should be eliminated. The only exception would be a young woman without any symptoms and with a single very small polyp, less than 1 cm. In this case, a follow-up will be necessary to monitor it and check if it disappears.

Questions from users

Are endometrial polyps and malignant uterine fibroids the same?

The polyps and myomas that appear in the uterus are not exactly the same, although they do have the same symptoms as bleeding. Fibroids, like polyps, are also a benign tumor with minimal risk of malignancy.

The difference between the two is that myomas are formed from the uterine muscle and can reach a large size, while polyps are formed from the endometrial tissue and can be removed on their own.

Can endometrial polyps appear in multiple ways?

Normally, endometrial polyps appear alone. However, in 20% of cases they occur in multiple ways and with different sizes: from a few millimeters to several centimeters. Multiple polyps cause more infertility problems because they can interfere with the passage of sperm through the female reproductive tract or embryo implantation.

Can a uterine polyp cause endometrial cancer?

Polyps are a type of endometrial hyperplasia in which the endometrial cells begin to proliferate basically due to an abnormal response by the increase of estrogen. This is a benign condition that, however, could progress to endometrial cancer, especially in menopausal women who have not received surgical treatment.

Recommended reading

We have talked about myomas as another type of tumor formation in the uterus. If you want to know more about this topic, you can continue reading the following post: The uterine myomatosis.

There are other uterine causes that can cause female infertility other than endometrial polyps. For more information about this, click on the following link: Female sterility due to a uterine factor.


hysteroscopic surgery in Cadiz(Spain)

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