Echogenic Uterine Fluid Collection as an Unusual Presentation of Endometrial Squamous Metaplasia

DOI: 10.1089/gyn.2012.0103


Background: The optimal management of intrauterine fluid accumulation in postmenopausal women with cer-vical stenosis is currently debatable. Diagnostic challenge still remains, because of the low accuracy of sono-graphic histologic prediction. Case: In the case described, an asymptomatic postmenopausal woman was found to have an echogenic endometrial fluid collection on pelvic ultrasound, suspicious for uterine malignancy. Results: After a failed attempt at endometrial sampling secondary to cervical stenosis, the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. The fluid-filled endometrial cavity was found to have extensive benign squamous differentiation. Conclusions: Extensive endometrial squamous metaplasia should be considered as a rare differential diagnosis when postmenopausal women are found to have echogenic intrauterine fluid collections on ultrasound. (J GYNECOL SURG 29:148)