0:01

Our next endometrial case is a 50-year-old

0:03

who came in for right ovarian cyst follow-up.

0:05

She is postmenopausal at 50 years old.

0:08

So we scroll through this sagittal

0:10

image through the uterus, transvaginal.

0:13

There's a lot going on in this patient as well.

0:15

You can see a lot of cystic change.

0:18

Some of this is going to potentially be blood

0:20

vessels, so you have to figure out if you

0:22

were in the uterus or cervix or next to it.

0:25

But we're going to concentrate on

0:25

the endometrium itself right here.

0:27

And we can see this is abnormally thickened.

0:28

She is postmenopausal per history.

0:31

That is about a 12-millimeter

0:32

stripe, which is too thick.

0:34

for postmenopausal and then

0:37

postmenopausal who is not bleeding.

0:39

But beyond that, we also have

0:40

abnormal morphology with all

0:42

of these cystic spaces in here.

0:43

So this needs a biopsy.

0:46

So we should also look at our color

0:48

Doppler ultrasound imaging to see if we

0:49

can see if there's vascularity to it.

0:51

It's not ultimately going

0:52

to change the management.

0:53

This still needs a biopsy, but it can

0:55

be helpful if it's very hypervascular

0:57

diffusely, if it's focally, maybe this

0:59

is a polyp can be helpful to give the

1:03

guide surgeon a little bit of a heads up.

1:05

And you can see in this particular case,

1:07

it is not really that hypervascular,

1:10

little bits of flow here and there.

1:12

She did end up going to get a biopsy,

1:14

of course, because this is abnormal

1:15

in a postmenopausal patient.

1:17

And they got disordered fragments

1:18

of proliferative endometrium.

1:20

This is considered a non-cancerous

1:22

diagnosis, but is a quote unquote

1:24

unusual growth of endometrial cells.

1:27

So in a case like this, she's going to need

1:28

close follow-up to see if this, you know,

1:30

comes back, or if there is a cancer, or if

1:32

it was just an undersampling type of problem.

1:35

So they'll keep watching her, and she'll

1:38

require follow-ups again to make sure

1:39

that she doesn't end up having a cancer.