ASYMPTOMATIC ENDOMETRIAL CARCINOMA AFTER ENDOMETRIAL ABLATION

Endometrial ablation has been recently introduced as a surgical altern ative to hysterectomy for the treatment of dysfunctional uterine bleed ing. The procedure itself is reasonably safe. However, if occult endom etrial cancer is present before the procedure and is not detected, it may be more difficult to diagnose later. Endometrial cancer may also a rise de novo from missed endometrial tissue. Two cases of endometrial cancer following endometrial ablation have been reported, but its over all incidence is unknown. A 58-year-old woman was treated with endomet rial ablation for dysfunctional uterine bleeding. Three years later sh e underwent hysterectomy and Marshall-Marchetti-Krantz procedure for u rinary incontinence; incidental, asymptomatic endometrial adenocarcino ma was discovered. The final pathology was grade 1 adenocarcinoma, inv ading more than 50% of the myometrium (FIGO stage Ic). Endometrial can cer may occur following endometrial ablation and it may be asymptomati c. Careful patient selection and close follow-up are essential.