It is important to characterize the polyp in terms of its vascularity and whether it is a sessile or pedunculated polyp. Also, in this large lesion, submucosal fibroid is an important differential consideration.

Although most submucosal fibroids are typically hypoechoic, in this case, it turned out to be an echogenic lesion, and very difficult to differentiate from an endometrial polyp. In retrospect, there appears to be a displaced curvilinear outline of endometrium overlying the lesion. One important modality which can help in such situations is sonohysterography ¹.