Overview

Cervical polyps are common, benign neoplasms of reproductive-age women. They appear as polypoid growths projecting into the cervical canal. They can be one of the most common causes of intermenstrual vaginal bleeding.

Most patients are perimenopausal at the time of presentation, especially in the 5th decade of life. They are the most common mass lesion of the cervix, with a reported prevalence of 1.5-10%

More than half of cases are asymptomatic. Symptoms can include menorrhagia, postmenopausal bleeding, contact bleeding, and vaginal discharge. The diagnosis is made primarily with hysteroscopy

Radiographic features

Ultrasound

• Sessile or pedunculated well-circumscribed masses within the endocervical canal
• May be hypoechoic or echogenic
• Identifying the stalk attaching to the cervical wall helps differentiate it from an endometrial polyp

Complications

• Can progress into carcinoma of the cervix in ~0.1% of cases.

Treatment and prognosis

Surgical removal is often the treatment of choice although some suggest initial monitoring for small polyps 7. Usually, recurrence is rare.

Differential diagnosis

For a polypoid lesion within the cervical canal consider:

• Pedunculated uterine leiomyoma protruding through the cervical canal
• Endometrial polyp protruding through the cervical canal
• Cervical cancer