Case notes
A 70-year-old woman (gravida 3, para 1) was referred for hysteroscopy because of an ultrasonographic suspicion of thickened endometrium ( Figure 1 ). She did not complain of bleeding but of mild lower abdominal pain and yellowish vaginal discharge. Diagnostic hysteroscopy was performed with a “no touch” method, without speculum, tenaculum, or anesthesia. Examination of the endometrial cavity revealed a midline septum, with benign polyps in the right side, and irregular, elevated, and highly vascularized lesions in the left side ( Figures 2-4 ). A guided biopsy confirmed endometrial cancer. Pathologic review after subsequent laparoscopic hysterectomy confirmed a 2-cm well-differentiated endometrial carcinoma, arising within the left horn that infiltrated less than the one-half of the myometrium.
