A case of endometrial atypical hyperplasia in a nineteen-year-old woman

A nineteen-year-old Japanese woman has complained of general fatigue and excessive menstrual bleeding. Medical workup revealed profound anemia without failure of hemostatic function. Subsequently, she underwent endometrial cytology and endometrial curettage due to assessing uterine bleeding. Endometrial cytology displayed abundant atypical cells with hemorrhagic background. Endometrial biopsy revealed advanced atypical hyperplasia. In this case a reproductive function should be preserved, so that hysterectomy specimen was not available. She has been treated by medroxyprogesterone acetate (MPA) since then. Four weeks later, a follow-up curettage appeared atrophic endometrium without malignant potential. We reported a rare case of endometrial hyperplasia in less than 20 years. Although appropriate treatment for this entity remains a controversial, we should account for endometrial pathology, potentially progressing to malignancy, in very young woman.