Journal of Ultrasound in Medicine, Vol 14, Issue 9 685-688, Copyright © 1995 by American Institute of Ultrasound in Medicine
Sonohysterography for ultrasonographic evaluation of tamoxifen-associated cystic thickened endometrium
R. Achiron, S. Lipitz, E. Sivan, M. Goldenberg and S. Mashiach
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Most menopausal patients with breast cancer receive tamoxifen therapy. In
these patients, TVS may show thickened, irregular cystic endometria. For
better visualization of these patients' uterine cavities, we performed
transvaginal sonohysterography. During vaginal ultrasonography, sterile
saline was introduced by transcervical 8 French Foley catheter into the
uterine cavity of 20 women who were referred with tamoxifen-associated
cystic thickened endometria. In eight women, transvaginal sonohysterography
provided the means to diagnose occult, free-floating endometrial polyps,
whereas in 12 women, the fluid contrast augmented the diagnosis of an
irregular cystic endometrial-myometrial junction. All 20 patients underwent
diagnostic hysteroscopy: eight polyps, none of which were malignant, were
confirmed and removed by hysteroscopic resection. Of the remaining 12
patients with an irregular endometrial-myometrial junction, endometrial
curettage showed no significant pathologic findings. Transvaginal
sonohysterography seems to enhance the differentiation between endometrial
polyps that should be resected by operative hysteroscopy and an abnormal
endometrial-myometrial junction that may benefit from biopsy sampling only.
