Question:medium
A 60-year-old woman presents with a history of intermittent bleeding. Her ultrasound is shown below. What is the diagnosis?
A 60-year-old woman presents with a history of intermittent bleeding. Her ultrasound is shown below. What is the diagnosis?
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A single central feeding vessel running into a focal endometrial lesion.
Updated On: Jun 23, 2026
- Endometrial polyp
- Carcinoma endometrium
- Submucosal fibroid
- None
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The Correct Option is A
Solution and Explanation
The vessel sign decides it: on Doppler and 3D ultrasound, a focal endometrial mass fed by one prominent central vessel is the textbook picture of an endometrial polyp. That solitary feeding artery, running into soft stroma with back-to-back glands, is what makes a polyp bleed on and off, matching this woman's intermittent bleeding.
Separate it from its mimics. Endometrial carcinoma in a 60-year-old is a worry, but it usually shows a thick, heterogeneous, irregular endometrium with multiple chaotic vessels and a blurred or breached endo-myometrial junction, not a clean single-pedicle lesion. A submucosal fibroid arises from the myometrium, indents the cavity, looks hypoechoic with posterior shadowing, and carries circumferential rim vascularity rather than one central stalk vessel.
Because the scan demonstrates a discrete fundal endometrial lesion with a single central feeding vessel, the diagnosis is an endometrial polyp. Note that postmenopausal bleeding still warrants histology to exclude malignancy. Ref: gynaecological ultrasound.
Separate it from its mimics. Endometrial carcinoma in a 60-year-old is a worry, but it usually shows a thick, heterogeneous, irregular endometrium with multiple chaotic vessels and a blurred or breached endo-myometrial junction, not a clean single-pedicle lesion. A submucosal fibroid arises from the myometrium, indents the cavity, looks hypoechoic with posterior shadowing, and carries circumferential rim vascularity rather than one central stalk vessel.
Because the scan demonstrates a discrete fundal endometrial lesion with a single central feeding vessel, the diagnosis is an endometrial polyp. Note that postmenopausal bleeding still warrants histology to exclude malignancy. Ref: gynaecological ultrasound.
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