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Complex hyperplasia w/"rare" atypia... Complex hyperplasia w/"rare" atypia...

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Unread 08-25-2008, 01:54 PM
Complex hyperplasia w/"rare" atypia...

Hi all - hoping just to get a little insight on this topic...

I had a VERY rough July - basically having an extremely heavy period with clotting most of that month. I was scheduled for some lab work and both abdominal and transvaginal ultrasounds. They found that my endometrium was thickened to more than double what it should be normally and the uterus was enlarged, as well. The doctor scheduled me for a D&C soon after...that's where the diagnosis and my question comes in...

The pathologist was concerned about the findings and sent the slides over to USC to an MD who specializes in GYN CA and pre-cancerous indicators. When my doctor called back with the final findings, he said that the specialist concurred with the original findings, adding that I have a 'rare' atypia. I have no idea what that means except that my doctor continually tells me there's absolutely no sign of cancer, cells or otherwise. Anyway, both doctors also agree that a hysterectomy is the only way to go.

What I'm wondering, though, is whether the chance of them finding cancer in the uterus or surrounding area is still possible if nothing at all was found in the endometrial biopsy?

I'm really not trying to turn my hair any grayer than it is or to scare myself...I'm really trying to arm myself with all the questions I need to ask at my pre-op and I know you ladies are experienced!

Thanks SO much in advance for any info you can share!!!

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Unread 08-25-2008, 04:13 PM
Complex hyperplasia w/"rare" atypia...

I really don't know what a "rare" type of atypia is and maybe someone else here has dealt with or heard of this. Perhaps you may want to get further information from your doctors re this DX too.
With complex hyperplasia with atypia which is pre-cancer while the cells are not consider normal they also are not considered cancerous but growing toward cancer. Surgery almost always is recommended because there is circa 30+% chance the cells can turn cancerous. Also, sometimes with this dx only surgery can reveal if cancer is present and this happened to me as none of the tests including the "gold standard",a D&C had shown cancer.
Usually we recommend that women with any hint of cancer consult with and have a gyn/onc do their surgery as they are the cancer experts.
Please let us know if you learn more re your dx and don't hesitate to ask further questions; etc. Someone seems to around almost 24/7.
Unread 08-25-2008, 04:24 PM
Complex hyperplasia w/"rare" atypia...

My first biopsy showed complex w/o atypia cells & second biopsy a few weeks later showed a grade 1 cancer. It didnt change in that short period of time, the first dr had probably taken the biopsy from the bottom of the uterus - the tumor was at the top.(second dr did a sonogram & saw the area that needed to be biopsied) There is the chance of a false negative with the biopsy. A D&C is more accurate(takes more tissue) but sinse you are already having a hysterectomy because of the atypia, it would probably not be helpful. When the actual surgery is performed with lab, then they can say with 100% certainty that it is not cancer. Have you decided whether to have ovaries removed? If by chance cancer is found in the uterus, will an onocologist be there to sample lymphnodes and check the wash? Chances are good that it is not cancer; however,if it is, many times surgery alone is the cure.
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Unread 08-25-2008, 04:59 PM
Complex hyperplasia w/"rare" atypia...

My dx was severe complex hyperplasia with atypia by d&c hysteroscopy, I was immediately referred to a gyn/onc. I am with the others, you want an oncologist to do the surgery just in case. Hope all goes well with you
Unread 08-25-2008, 08:11 PM
Complex hyperplasia w/"rare" atypia...

Yes, the doctor has already indicated that I am to have a TAH with BSO. Originally, I was hoping to keep the ovaries because I've been tested for oviarian function and I'm not in menopause - they are functioning normally - even though I'll be 53 next week. When I heard BSO, I was kind of shocked and wanted to argue the fact, but did not. I discussed with my fiance and he agrees that, while they function normally, why take a chance. Made me think it through and I agree now.

And, I did have a complete D&C - the pathology was just part of the normal process...the pathologist was the one that suggested sending to Dr. Felix @ USC. This had me concerned because I did look him up and found what his specialty and interests were...but, at the same time, I was relieved because I was reassured that he also found no evidence of cancer.

This site has been such a source of information and gives such a sense of family! I'm SO grateful to have found it and all of you!!!
Unread 08-25-2008, 08:33 PM
Complex hyperplasia w/"rare" atypia...

I was 45 & never had any premenapausal symptoms or problems with my period. My ovaries were normal when they took them but keeping them would increase chances of reoccurance of a hormone sensitive cancer. If your hyperplasia is caused by hormones then it is probably best to have them removed even if they are functioning normally.
I misunderstood & thought you had a biopsy done. D&C should have a much lesser percent of false negatives with the greater amount of tissue sampled. Even so, have the oncologist do or assist with the surgery.

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