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Gynecology

Enlarged uterus and thickening uterus lining?

03/06/2008

Question:

My doctor has been monitoring my enlarged uterus for some time. I have always had long, heavy periods with clotting since age 11 and I am now 48 years old and still going strong. My monthly cycles have lightened us slightly - heavy for the first 3 days and then light for 2 to 4 month days on alternating months. I had an ultra sound in 2006 that showed my uterus was twice the size of a normal uterus (doctor says that of a 12 week pregnant woman- I was told early on that this was good - more room for babies) However, in 2006 the lining measured 1.2 approx and now 2 years later measures 2.something. Doctor says uterus size is still the same but lining thicker. I had a negative uterine biopsy in 2006. Paps have all been negative. Last pap two weeks ago and reported too few cells to read pap. doctor recommends, hysterectomy and repair of fallen bladder at the same time. Question? If this is potentially uterine cancer would a hysterectomy be recommended or wold the uterus need to be there to perform radiation therapy or chemo? Would a hysterectomy be the only true way to diagnosis uterine cancer and /or should a uterus biopsy be performed again before a hysterectomy? and a pap?

Answer:

The measurement of the lining of the uterus isn't important for diagnosing uterine cancer in women who aren't in menopause. Furthermore, you had an endometrial biopsy that was normal and therefore cancer has been ruled out. If uterine cancer was present, a hysterectomy is the best and first line treatment. The pap can find uterine cancer, but isn't designed to be a screening test for it.

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Response by:

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated