Lapis ISSN 2398-2969

Endometrial hyperplasia

Contributor(s): Sarah Pellett, Vladimir Jekl

Introduction

  • Cause: aging changes. It is believed to result from prolonged estrogenic and progesteronic stimulation, however the role of estrogen in the development of uterine adenocarcinoma from endometrial hyperplasia was not proven.
  • Signs: hematuria, bloody vulval discharge, palpably enlarged uterus. Cystic mammary glands can also be seen.
  • Diagnosis: radiography, ultrasonography, exploratory surgery and histopathology.
  • Treatment: ovariohysterectomy.
  • Prognosis: good prognosis after ovariohysterectomy if endometrial hyperplasia is present without further pathologies.
Print out the Owner Factsheet Uterine problems to give to your client.

Pathogenesis

Etiology

  • Aging changes, with some sources describing a continuum from endometrial hyperplasia (polyps) to development of adenocarcinoma Uterine adenocarcinoma. Other sources state that there is no clear relationship with uterine adenocarcinoma, and adenocarcinomatous endometrial changes are simply a consequence of age-related atrophy of the endometrium with no association with cystic endometrial hyperplasia. The role of estrogen in the development of uterine adenocarcinoma from endometrial hyperplasia is controversial.
  • In one publication, endometrial hyperplasia has been reported to be the second most common uterine pathology seen on post-mortem examination. Glandular-cystic changes were seen in most cases. Endometrial hyperplasia was found more often in slightly younger animals with the incidence increasing with age.
  • In brown hares in Australia, endometrial hyperplasia and other uterine changes were observed in older hares exposed to estrogens in certain food crops.

Predisposing factors

General

  • Entire female rabbits.
  • Most frequently seen in rabbits 4 years or older.

Pathophysiology

  • Characterized by thickening of the endometrium, cystic development of mucus-filled glands and accumulation of mucus in the lumen of the uterus (rare).

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bertram C A, Müller K & Klopfleisch R (2018) Genital Tract Pathology in Female Pet Rabbits (Oryctolagus cuniculus): a Retrospective Study of 854 Necropsy Examinations and 152 Biopsy Samples. J Comp Pathol 164, 17-26 PubMed.
  • Harcourt-Brown F M (2017) Disorders of the reproductive tract of rabbits. Vet Clin North Am Exot Anim Pract 20 (2), 555-587 PubMed.
  • Vinci A, Bacci B, Benazzi C et al (2010) Progesterone receptor expression and proliferative activity in uterine tumours of pet rabbits. J Comp Pathol 142 (4), 323-327 PubMed.
  • Walter B, Poth T, Böhmer E et al (2010) Uterine disorders in 59 rabbits. Vet Rec 166 (8), 230-233 PubMed.
  • Asakawa M G, Goldschmidt M H, Une Y et al (2008) The immunohistochemical evaluation of estrogen receptor-α and progesterone receptors of normal, hyperplastic, and neoplastic endometrium in 88 pet rabbits. Vet Pathol 45 (2), 217-225 PubMed.
  • Scott P & Wight N (2004) Female reproductive tract abnormalities in European hares (Lepus europeaus) in Australia. J Wildl Dis 40 (4), 696-703 PubMed.
  • Saito K, Nakanishi M & Hasegawa A (2002) Uterine disorders diagnosed by ventrotomy in 47 rabbits. J Vet Med Sci 64 (6), 495-497 PubMed.
  • Paul-Murphy J & Ramer J C (1998) Urgent care of the pet rabbit. Vet Clin North Am Exotic Anim Pract 1 (1), 127-152 PubMed.
  • Garibaldi B A, Fox J G, Otto G et al (1987) Hematuria in rabbits. Lab Anim Sci 37 (6), 769-772 PubMed.
  • Elsinghorst T A, Timmermans H J & Hendrix H G (1984) Comparative pathology of endometrial carcinoma. Vet Q 6 (4), 200-208 PubMed.
  • Baba M & von Haam E (1972) Animal models: spontaneous adenocarcinoma in aged rabbits. Am J Pathol 68 (3), 653-656 PubMed.

Other sources of information

  • Bourne D (online) Endometrial Hyperplasia / Uterine Polyps in Lagomorphs. Website: http://wildpro.twycrosszoo.org. Last accessed 20th March 2019.
  • Mancinelli E & Lord B (2014) Urogenital System and Reproductive Disease. In: BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B. BSAVA, UK. pp 191-204.
  • Varga M (2013) Uterine Disorders. In: Clinical Veterinary Advisor: Birds and Exotic Pets. Eds: Mayer J & Donnelly T M. Elsevier, USA. pp 424-426.
  • Ewringmann A (2005) Ed. Vaginalausfluss. In: Leitsymptome beim Kaninchen. Enke Verlag, Germany. pp 125-136.
  • Kraus A L, Weisbroth S H, Flatt R E et al (1984) Biology and Diseases of Rabbits. In: Laboratory Animal Medicine. Eds: Fox J G et al. Academic Press, USA. pp 207-240.


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