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Abnormally thickened endometrium (differential)

Last revised by Dr Jeremy Jones on 20 Sep 2021

Abnormally thickened endometrium on imaging may occur for a number of reasons which may be categorized based on whether or not they are related to pregnancy. Etiologies may also be classified based on whether the patient is premenopausal or postmenopausal.

  • endometrial thickness in the secretory phase (days 14-28) may normally be up to 12-16 mm (see: endometrial thickness)
    • non-emergent ultrasounds are optimally evaluated at day 5-10 of the menstrual cycle to reduce the wide variation in endometrial thickness
  • the thickest portion of the endometrium should be measured
  • if there is fluid in the uterine cavity, it should be excluded from the measurement, which would be the sum of the two sagittal plane thicknesses
  • ~10% of endometrial carcinoma occurs in premenopausal women

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Cases and figures

  • Case 1: Tamoxifen induced
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  • Case 2: molar gestation
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  • Case 3: retained products
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  • Case 4: endometrial polyp
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