Is hysteroscopic appearance a safe means of differentiating malignant from benign endometrial polyps in postmenopausal women?

Objective To determine whether the hysteroscopic appearance of endometrial polyps in postmenopausal women offers a safe method of differentiating premalignant and malignant polyps from those that are benign. Design We performed a retrospective analysis of 60 postmenopausal patients with endometrial polyps evaluated by diagnostic hysteroscopy. These polyps were histologically examined after removal in all patients. Results All polyps had a benign hysteroscopic appearance. Histological findings were: endometrial polyp without atypia in 57 patients (95%), endometrial polyp with mild atypia in one patient (1.7%), and clear‐cell adenocarcinoma in two patients (3.3%). Conclusion Hysteroscopic appearance did not provide a safe method of differentiating malignant and atypical from benign endometrial polyps. The presence of endometrial neoplasia in our series argues for the histological diagnosis of endometrial polyps occurring after the menopause.