Reproductive preservation for treatment of stage IA endometrial cancer in a young woman: Hysteroscopic resection

Abstract

Uterine cancer is the most common type of gynecological neoplasm. Conventionally, the standard treatment for early-stage endometrial cancer is surgical staging with hysterectomy, bilateral salpingooophorectomy, and lymph node assessment. However, this leads to definitive sterilization in reproductive-age women. We report a rare case of a young woman with endometrioid endometrial adenocarcinoma successfully treated with reproductive preservation therapy in order to preserve her uterus. Pretreatment evaluation including tumor grade, depth of myometrial invasion, tumor size, and hormone-receptor status indicated a favorable prognosis. The patient was treated with hysteroscopic resection of the endometrial cancer, of the endometrium near lesion, and of the myometrium under lesion plus hormone therapy. Thirty months after operative hysteroscopy, the patient has given birth by cesarean section at 39 weeks of gestation to a male child of 3.2 kg and is now completely free of disease. We therefore conclude that there may be a role for effective treatment of endometrioid carcinomas with preservation of reproductive capacity, even if our preliminary result should be validated by a longer follow-up. © 2005 IGCS.