Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9629-9634
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9629
Atypical endometrial hyperplasia in a 35-year-old woman: A case report and literature review
Xiang Wu, Jun Luo, Fei Wu, Neng Li, Ai-Qiong Tang, Ang Li, Xiao-Ling Tang, Min Chen
Xiang Wu, Jun Luo, Fei Wu, Neng Li, Ai-Qiong Tang, Ang Li, Department I of Gynecology, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410007, Hunan Province, China
Xiao-Ling Tang, Ultrasonography Department, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410007, Hunan Province, China
Min Chen, Pathology Department, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410007, Hunan Province, China
Author contributions: Tang AQ, Li N, and Li A contributed equally to this work to analyzed the data; Chen M and Tang XL were responsible for the data management; Luo J contributed to the development of the project; Wu F collected the data; Wu X contributed to the development of the project, collected the data, and drafted the manuscript; and all authors have read and approve the final manuscript.
Informed consent statement: This study was conducted in accordance with the Declaration of Helsinki. This study was also conducted with approval from the Ethics Committee of Hunan Provincial Maternal and Child Health Care Hospital. Written informed consent was obtained from participant as well.
Conflict-of-interest statement: Each author declares having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang Wu, MD, Chief Doctor, Department I of Gynecology, Hunan Provincial Maternal and Child Health Care Hospital, No. 53 Xiangchun Road, Changsha 410008, Hunan Province, China. wx-vivi@126.com
Received: July 15, 2021
Peer-review started: July 15, 2021
First decision: August 19, 2021
Revised: September 1, 2021
Accepted: September 10, 2021
Article in press: September 10, 2021
Published online: November 6, 2021
Processing time: 106 Days and 4.6 Hours
Abstract
BACKGROUND

Atypical endometrial hyperplasia (AEH) is a common precancerous lesion of endometrial carcinoma (EC). The risk factors for AEH and EC directly or indirectly related to estrogen exposure include early menarche, nulliparity, polycystic ovarian syndrome, diabetes, and obesity. Both AEH and EC rarely occur in young patients (< 40-years-old), who may desire to maintain their fertility. Evaluating the cancer risk of AEH patients is helpful for the determination of therapeutic plans.

CASE SUMMARY

We report a rare case of AEH in a 35-year-old woman who presented to the Hunan Provincial Maternal and Child Health Care Hospital with a large mass in the uterus. She married at 20-years-old, and had been married for more than 15 years to date. Several characteristics of this patient were observed, including nulliparity, limited sexual activity (intercourse 1-2 times a year) in recent years, and irregular vaginal bleeding for 2 years. Gynecological examination revealed an enlarged uterus, similar to the uterus size in the fourth month of pregnancy, and the uterine wall was relatively hard. Curettage was performed based on transvaginal sonography and magnetic resonance imaging results. Findings from the pathological examination were typical for AEH. The patient was cured after treatment with the standard therapy of high-dose progesterone.

CONCLUSION

In patients with intrauterine lumps that may be malignant, a pathological report should be obtained.

Keywords: Atypical endometrial hyperplasia; Abnormal uterine bleeding; Infertility; Large mass in the uterus; Case report

Core Tip: We report a rare case of atypical endometrial hyperplasia in a 35-year-old woman, who presented with a large mass in the uterus. Several characteristics were observed, including nulliparity, limited sexual activity in recent years, and irregular vaginal bleeding for 2 years. Gynecological examination revealed an enlarged uterus, and the uterine wall was relatively hard. Curettage was applied based on transvaginal sonography and magnetic resonance imaging results. The pathological examination findings were typical for atypical endometrial hyperplasia. The patient was cured after treatment with a high dose of progesterone. The findings from this case study will be valuable in clinical practice.