The child is normally developed. Despite not taking thyroid hormone replacement medication, she did not become hypothyroid. She had been noted to be large for dates. No fetus was present grossly or by ultrasound. A 46 year old female has had irregular menses for several months.
Pelvic examination is normal, and an abdominal ultrasound reveals no mass lesions.
The uterus appears normal in size. An endometrial biopsy is performed and demonstrates a proliferative pattern. He refers her to a gynecologist, who performs an endometrial biopsy that reveals atypical adenomatous hyperplasia.