Abdominal dissemination of malignant cells with hysteroscopy.
The increase in uterine pressure during hysteroscopy may lead to dissemination of malignant cells into the abdominal cavity. 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. Viability and peritoneal implantation of these disseminated cells are questionable. However, routine hysteroscopy in cases of suspected endometrial carcinoma should not be recommended.