Malignant uterine polyps: types, symptoms and treatments

Uterine or endometrial polyps are outgrowths from the lining of the womb or tumors that form when the endometrium grows abnormally. Broadly speaking, most uterine polyps are benign, but unfortunately it is estimated that about 5% turn into cancer.

The size and symptoms of polyps vary from woman to woman. As for the best treatment option, polyps should be surgically removed to prevent them from becoming cancerous.

What types of polyps are there?

Uterine polyps are caused by endometrial hyperplasia, that is to say, exaggerated formations of endometrial tissue. Part of endometrial tissue proliferates independently and is not shed with menstruation. This excess endometrial tissue remains in the uterus and continues growing.

The main cause of endometrial polyp formation and growth are hormonal imbalances, in particular, when the levels of estrogens are too elevated.

There exist two types of endometrial polyps, as one shall see below:

Functional polyps

They are dependent on female sex hormones, particularly estrogen and progesterone. They are always benign.

Organic polyps

They do not depend on sex hormones, and are cancerous in 1% percent of the cases.

Location of malignant endometrial polyps

Organic uterine polyps are more common after menopause and should always be removed, irrespective or whether the patient has symptoms like bleeding or are asymptomatic.

Causes

In general, the causes of endometrial polyps are still unknown, although there exist certain risk factors such as advanced age or obesity.

In the particular case of cancerous polyps, they are more common amongst perimenopausal and postmenopausal women aged between 40 and 65 years.

Women on Tamoxifen for the treatment of cancer have a higher chance of developing cancerous endometrial polyps. For this reason, attending routine gynecological examinations is crucial as a preventive measure.

What symptoms do malignant polyps cause?

Most endometrial polyps have no symptoms and the woman is not aware of them until she gets a diagnosis after a routine gynecological exam.

However, cancerous polyps are larger in size than benign polyps and are usually associated with the following symptoms:

• Hypermenorrhea, i.e. abnormally heavy or prolonged menstruation
• Metrorrhagia or intermenstrual bleeding, i.e. bleeding between periods
• Postmenopausal bleeding
• Anemia
• Bleeding after sexual intercourse if the polyp is located in the cervix
• Leukorrhea, i.e. thick, whitish or yellowish vaginal discharge

Possible clinical manifestations of malignant endometrial polyps

Although to a lesser extent, and depending on the size, uterine polyps may lead to female infertility by creating a blockage in the uterus that prevents embryo implantation.

Treatment

Functional polyps are not cancerous, and in fact they can disappear spontaneously if they are small.

Also, if they are symptomatic or are organic, they should be surgically removed as soon as possible to prevent them from turning into cancer.

Polyps are removed using a surgical procedure called hysteroscopic polypectomy. It involves the insertion of a hysteroscope vaginally in order to detect and remove the polyp by cutting or shaving it off.

Polypectomy procedure

Researchers have found an association of 10% between uterine polyps and endometrial carcinomas in postmenopausal women. This is the reason why removing them at once is so important. Afterwards, doing a biopsy of the polypectomy site is strongly recommended in order to determine whether the polyps were cancerous (malignant) or non-cancerous (benign).

Ideally, all kinds of endometrial polyps should be removed. The only exception to this rule would be in the case of a young woman without symptoms associated, and an isolated polyp of 1 cm. In such case, a close follow-up would be required to see if it goes away on its own eventually.

FAQs from users

Do uterine polyps affect fertility?

Uterine polyps are benign fibroglandular growths found inside the uterine cavity. Many times, uterine polyps are diagnosed by ultrasound during sterility study tests or during stimulation in ovarian stimulation treatments.

Polyps may act as a mechanism that makes it difficult for embryos to implant. Medical studies show that uterine polyps larger than 1 cm may interfere with the implantation process. Although the evidence does not show that they have a very deleterious impact on implantation rates, normally before IVF if we identify a polyp, even one smaller than 1 cm, we recommend removal of the polyp.

Polyps are removed by hysteroscopy, a technique that involves inserting a tube connected to a video camera through the cervix.

Do uterine polyps mean cancer?

No. In fact, it is estimated that only 5 percent become cancerous. This is the reason why endometrial polyps should be surgically removed as soon as they are detected.

What do cancerous uterine polyps look like?

Apparently, they are no different in color or texture. However, some studies have found an association between endometrial thickening, the size of polyps, and the chances for them to become cancerous—the larger the polyp, the greater endometrial thickness and subsequently the higher the chances for them to be cancerous.

Can benign uterine polyps become cancerous?

Yes. In this case, they are called precancerous polyps. All organic endometrial polyps can eventually turn into cancer if not removed on time.

Are uterine polyps cancerous?

There is no reason why. Most polyps that appear in the uterus are benign, but there are about 5% that become malignant. The important thing is to monitor this growth in the uterus and, if it causes symptoms such as abnormal bleeding, it should be removed.

Suggested for you

We have made reference to fibroids as another type of tumors that may grown in the uterine lining. Click here to learn more: What Are Uterine Fibroids? - Causes, Symptoms & Treatment.

Also, there exist other causes of uterine origin that can cause female infertility. Check out this for information: Uterine Factor Infertility – Diagnosis, Characteristics & Treatment.