Cervical polyps are polypoid growths projecting into the cervical canal. They can be one of the most common causes of intermenstrual vaginal bleeding.
Most patients are perimenopausal at the time of presentation, especially in the 5th decade of life. They are the most common mass lesion of the cervix, with a reported prevalence of 1.5-10%
More than half of cases are asymptomatic. Symptoms can include menorrhagia, postmenopausal bleeding, contact bleeding, and vaginal discharge. The diagnosis is made primarily with hysteroscopy.
Histologically, cervical polypoid lesions encompass a spectrum pathologic entities which include endocervical or endometrial tissue with metaplasia.
The polyps are usually pedunculated, often with a slender pedicle of varying length, but some can be sessile.
Approximately 25% of patient may also have a co-existing endometrial polyp 2.
- sessile or pedunculated well-circumscribed masses within the endocervical canal
- may be hypoechoic or echogenic
- identifying the stalk attaching to the cervical wall helps differentiate it from an endometrial polyp
Can progress into carcinoma of the cervix in ~0.1% of cases.
Treatment and prognosis
Surgical removal is often the treatment of choice although some suggest initial monitoring for small polyps 7. Usually recurrence is rare.
For a polypoid lesion within the cervical canal consider:
- pedunculated uterine leiomyoma protruding through the cervical canal
- endometrial polyp protruding through the cervical canal
- blood clot (mimic)
- 1. Okamoto Y, Tanaka YO, Nishida M et-al. MR imaging of the uterine cervix: imaging-pathologic correlation. Radiographics. 23 (2): 425-45. doi:10.1148/rg.232025065 - Pubmed citation
- 2. Stamatellos I, Stamatopoulos P, Bontis J. The role of hysteroscopy in the current management of the cervical polyps. Arch. Gynecol. Obstet. 2007;276 (4): 299-303. Arch. Gynecol. Obstet. (full text) - doi:10.1007/s00404-007-0417-2 - Pubmed citation
- 3. Robertson M, Scott P, Ellwood DA et-al. Endocervical polyp in pregnancy: gray scale and color Doppler images and essential considerations in pregnancy. Ultrasound Obstet Gynecol. 2005;26 (5): 583-4. Ultrasound Obstet Gynecol (full text) - doi:10.1002/uog.1992 - Pubmed citation
- 4. Spiewankiewicz B, StelmachóW J, Sawicki W et-al. Hysteroscopy in cases of cervical polyps. Eur. J. Gynaecol. Oncol. 2003;24 (1): 67-9. Pubmed citation
- 5. Chu LC, Coquia SF, Hamper UM. Ultrasonography evaluation of pelvic masses. Radiol. Clin. North Am. 2014;52 (6): 1237-52. doi:10.1016/j.rcl.2014.07.003 - Pubmed citation
- 6. Radiology of the Female Pelvic Organs (Medical Radiology). Springer. ISBN:3642643248. Read it at Google Books - Find it at Amazon
- 7. Tanos V, Berry KE, Seikkula J, Abi Raad E, Stavroulis A, Sleiman Z, Campo R, Gordts S. The management of polyps in female reproductive organs. (2017) International journal of surgery (London, England). 43: 7-16. doi:10.1016/j.ijsu.2017.05.012 - Pubmed
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