Abdominal dissemination of malignant cells with hysteroscopy

Background: The increase in uterine pressure during hysteroscopy may lead to dissemination of malignant cells into the abdominal cavity. Case: In a patient with adenocarcinoma of the endometrium, hysteroscopy was performed after peritoneal cytology had been obtained by washing with saline. In contrast to this first washing, a second peritoneal lavage immediately after hysteroscopy led to positive cytology. Conclusion: Viability and peritoneal implantation of these disseminated cells are questionable. However, routine hysteroscopy in cases of suspected endometrial carcinoma should not be recommended. (C) 1996 Academic Press, Inc.