• atipica
• endometriale
• iperplasia

Objective: assessing the rationale for endometrial resection as exclusive therapy in atypical endometrial hyperplasia (AEH).
Study design: A prospective monocentric observational study (Canadian Task Force Design Classification II-2) from performed from January 2000 to March 2023, including 49 patients with histologically proven endometrial AHE. Initial diagnosis was retrieved by histological assessment of endometrial samples collected during office hysteroscopy. Patients all underwent transcervical endometrial resection (TCRE) and in those with confirmed diagnosis, but that refused hysterectomy or progestin therapy as first line therapy, were asked to accept a follow up consisting of endometrial cavity assessment by transvaginal ultrasound and hysteroscopy at 3, 6 and 12 months after TCRE, and then yearly, with endometrial biopsies performed by hysteroscopy.
Results: after TCRE, endometrial cancer (EC) was detected in 19 out of 49 patients, that accepted to be treated by hysterectomy with bilateral salpingo-oophorectomy (HBSO). In the remaining 30 women, AEH was the unique endometrial lesion retrieved: they refused treatment and therefore were followed as above mentioned. All the patients progressed into EC after a follow-up period ranging from 6 to 84 months, when they finally accepted surgical therapy.
Conclusion: in post-menopausal women AEH ever progresses to cancer in a time longer that the 24 months follow up recommended