Hysteroscopy in the evaluation and treatment of mucinous adenocarcinoma

BACKGROUND: Hysteroscopy to evaluate abnormal uterine bleeding is gaining popularity. The standard methods of evaluation, endocervical curettage, and endometrial biopsy frequently diagnose adenocarcinoma without determining location. Because the treatments of endometrial and endocervical cancers are different, knowing the neoplastic origin is desirable. CASES: Two postmenopausal women were referred for abnormal uterine bleeding. Endometrial biopsies were consistent with mucinous adenocarcinoma without distinction between cervical and endometrial sites. Endocervical curettages were inconclusive. Both patients underwent hysteroscopy at the time of exploratory laparotomy, which revealed the location of the adenocarcinomas, one in the endocervix and one in the uterine fundus. CONCLUSION: The location of adenocarcinoma may be further clarified by the use of intraoperative hysteroscopy, which can aid in determining surgical treatment.