**2. Materials and Methods**

The study was retrospectively conducted on patients who underwent hysterectomy for AEH at the Obstetrics and Gynecology University Department of Mauriziano Umberto I Hospital in Turin from January 2015 to September 2022.

Data were retrieved through a retrospective review of hospital medical records.

The inclusion criteria were women diagnosed with AEH on hysteroscopic endometrial biopsy with a subsequent total hysterectomy and bilateral salpingo-oophorectomy and histopathological examination of the uterus.

The exclusion criteria were the absence of any available report of preoperative ultrasound examination and/or endometrial biopsy, and women who were conservatively managed and/or received medical therapy before surgery.

All patients were referred to our center for diagnostic evaluation, including transvaginal ultrasound (TVUS) and hysteroscopy for abnormal uterine bleeding or after the finding of sonographic anomalies of the endometrium during a routine scan at outpatient clinics. Diagnostic protocol at our center routinely included:


TVUS was always performed at our center before the hysteroscopy assessment.

After the diagnosis, all the patients included in the study underwent a total hysterectomy and bilateral salpingo-oophorectomy according to the management suggested by the main international guidelines [10,11]. Histopathological examination of the uterus was obtained, either confirming AEH or revealing EC.

Data were retrospectively collected about:

