Pokhrel Kailash Mani, Pokhrel Popular, Mulmi Utsha, Khanal Kapil, Panthi Anup, Aryal Suraj, Ghimire Asmita
Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University.
B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Ann Med Surg (Lond). 2024 Jan 3;86(2):1215-1219. doi: 10.1097/MS9.0000000000001667. eCollection 2024 Feb.
Endometrial polyps (EPs) result from the overgrowth of endometrial glands and stroma. Giant endometrial polyps, defined as those exceeding 4 cm, are rare, and their association with phytoestrogen (PE) intake is infrequently reported.
The authors present a case of a giant endometrial polyp in a 59-year-old post-menopausal woman from Nepal. The patient presented with lower abdominal pain and a history of vaginal spotting. She was not under any drugs or medications, including hormones, but had a regular intake of PE-rich foods. Imaging revealed a giant endometrial polyp and a uterine fibroid. Total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) were performed and histopathology examination confirmed the diagnosis of endometrial polyp and fibroid.
In our case, the patient's increased age and PE-rich diet were identified as potential risk factors for the giant endometrial polyp. Giant endometrial polyps are rare, with limited cases reported to date, often associated with tamoxifen or raloxifene use. Phytoestrogens can exhibit oestrogenic effects, contributing to endometrial polyps. This case emphasizes the importance of further research to explain the relationship between phytoestrogen intake and giant endometrial polyps.
Giant endometrial polyps are uncommon, and their association with phytoestrogen intake remains underexplored. Clinicians should consider dietary factors in history while evaluating endometrial polyps, and further research is necessary to explore the potential role of phytoestrogens in the development of giant endometrial polyps.
子宫内膜息肉(EPs)是由子宫内膜腺体和间质过度生长所致。巨大子宫内膜息肉是指直径超过4厘米的息肉,较为罕见,其与植物雌激素(PE)摄入之间的关联鲜有报道。
作者报告了一例来自尼泊尔的59岁绝经后女性患有巨大子宫内膜息肉的病例。该患者出现下腹部疼痛并有阴道点滴出血史。她未服用任何药物,包括激素,但有规律地摄入富含PE的食物。影像学检查发现一个巨大子宫内膜息肉和一个子宫肌瘤。实施了全腹子宫切除术和双侧输卵管卵巢切除术(TAH-BSO),组织病理学检查确诊为子宫内膜息肉和肌瘤。
在我们的病例中,患者年龄增长和富含PE的饮食被确定为巨大子宫内膜息肉的潜在危险因素。巨大子宫内膜息肉较为罕见,迄今为止报道的病例有限,通常与他莫昔芬或雷洛昔芬的使用有关。植物雌激素可表现出雌激素效应,促使子宫内膜息肉形成。该病例强调了进一步研究以解释植物雌激素摄入与巨大子宫内膜息肉之间关系的重要性。
巨大子宫内膜息肉并不常见,其与植物雌激素摄入之间的关联仍未得到充分研究。临床医生在评估子宫内膜息肉时应在病史中考虑饮食因素,并且有必要进一步研究以探索植物雌激素在巨大子宫内膜息肉发生发展中的潜在作用。