Case of the Week # 247

Adam Paer, MD Philippe Jeanty, MD.

Answer

Case Report

The following images show a few cases of maternal endometrial polyps seen during early pregnancies. As everyone else we had had the initial impression that these were somehow "blood clots" but could not figure out why they would looks so "round". Then one day we had a patient attempting to get pregnant. On her sonohystero to assess her tubes, we found a polyp. The plan was to remove the polyp before the pregnancy, but she spontaneously got pregnant before (a common story when we do air sonohystero of the tubes). And during her first trimester exam we could see the polyp adjacent to the sac (case #2 below). Something that I have not clarified is why the echogenicity of those polyp vary so much. Some look hypoechoic, some look isoechoic to the myometrium (of course mucosal pedunculated fibroids are a differential of endometrial polyp). Over the years we see those from time to time. We still recommend removal (so that the embryo does not implant on it).