University College Hospital, London, UK.
Ultrasound Obstet Gynecol. 2012 Jan;39(1):106-9. doi: 10.1002/uog.9062. Epub 2011 Dec 5.
Endometrial cancer is the commonest cancer of the female genital tract in the developed world. Ultrasound measurement of endometrial thickness is commonly used to triage patients with postmenopausal bleeding for histological sampling. The sensitivity of ultrasound in diagnosing endometrial cancer is high, but it has a small, well-defined false-negative rate. In this report we describe two cases, with histological confirmation, of postmenopausal women without any vaginal bleeding, who were subsequently diagnosed with advanced endometrial cancer. They were found to have a thin, normal endometrium on ultrasound. In both cases, histological examination was suggestive of endometrial cancer originating from foci of adenomyosis. These findings suggest that a proportion of the false-negative diagnoses of endometrial cancer on ultrasound could be caused by the disease being confined to the myometrium rather than as a result of suboptimal performance of ultrasound examination.
子宫内膜癌是发达国家女性生殖道最常见的癌症。超声测量子宫内膜厚度常用于对绝经后出血患者进行组织学取样进行分类。超声诊断子宫内膜癌的灵敏度很高，但假阴性率很小且明确。在本报告中，我们描述了两例经组织学证实的绝经后无阴道出血的妇女，随后被诊断为晚期子宫内膜癌。她们的超声检查显示子宫内膜薄且正常。在这两种情况下，组织学检查均提示子宫内膜癌起源于子宫腺肌病病灶。这些发现表明，超声检查中子宫内膜癌的一部分假阴性诊断可能是由于疾病局限于子宫肌层，而不是由于超声检查表现不佳所致。
