ENDOMETRIAL CARCINOMA ARISING WITHIN EXTENSIVE INTRAUTERINE SYNECHIAE

In patients with intrauterine adhesions severe enough to produce ameno rrhoea, biologically active endometrium can undergo malignant change. To our knowledge, this is the first reported case of endometrial carci noma arising within intrauterine synechiae. A 71-year-old woman receiv ing unopposed estrogen developed post-menopausal bleeding. At endovagi nal sonography we detected a polypoid mass. Extensive intrauterine syn echiae within the uterus were noted during hysteroscopy, and a polypoi d lesion was seen adjacent to a synechia. Biopsy demonstrated endometr ial adenocarcinoma arising from a synechia. Hysterectomy and bilateral salpingo-oophorectomy were performed. A well-differentiated adenocarc inoma of the endometrium was demonstrated. Asherman syndrome and endom etrial adenocarcinoma can exist simultaneously. In such cases, hystero scopy is essential for diagnosis of synechiae and for target biopsy.