Differential Diagnosis for a 1 cm Uterine Polyp

Single Most Likely Diagnosis

• Endometrial polyp: This is the most common and likely diagnosis for a 1 cm uterine polyp. Endometrial polyps are growths in the lining of the uterus (endometrium) and can cause abnormal uterine bleeding. They are usually benign but can sometimes be precancerous or cancerous.

Other Likely Diagnoses

• Submucosal fibroid: Although less common than endometrial polyps for a lesion of this size, submucosal fibroids can present similarly and cause bleeding symptoms. They are benign tumors that grow in the uterine wall.
• Hyperplastic polyp: A type of endometrial polyp that can be associated with hormonal influences, similar to endometrial polyps but with a different histological appearance.
• Atypical polypoid adenomyoma: A rare type of polyp that can mimic endometrial polyps but has a different cellular structure, sometimes associated with adenomyosis.

Do Not Miss Diagnoses

• Endometrial carcinoma: Although less likely, it is crucial not to miss endometrial cancer, which can present as a polypoid mass in the uterus. Early detection significantly improves prognosis.
• Sarcoma (e.g., uterine leiomyosarcoma): Extremely rare but potentially deadly, sarcomas can sometimes present as uterine masses. Their aggressive nature makes early diagnosis critical.

Rare Diagnoses

• Mullerian adenosarcoma: A rare malignant tumor that can present as a polypoid mass in the uterus.
• Uterine metastasis: Rarely, metastases from other cancers can present as uterine polyps, especially in patients with known primary malignancies.
• Inverted uterine papilloma: A rare, usually benign tumor that can grow into the uterine cavity and mimic a polyp.

Each of these diagnoses has different implications for treatment and prognosis, highlighting the importance of accurate diagnosis, usually through a combination of imaging studies and histopathological examination of the polyp after removal.