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Published on: January 22, 2022
Stage IV endometrial cancer after failed conservative management: a case report
Rajul Kothari1, Leigh Seamon, David Cohn
1Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Medical Center, Columbus, OH 43210, USA. rajul.kothari@osumc.edu
Background:
With younger women becoming increasingly overweight, endometrial cancer is becoming a concern in this group. These women are likely to desire fertility preservation. There are no randomized controlled data to guide conservative therapy.
Case:
A 24-year-old female with endometrial adenocarcinoma diagnosed in December 2003 was treated conservatively with Megace and levonorgestrel intrauterine device. She was lost to follow-up and represented in March 2006. Endometrial biopsy revealed grade 1 endometrial adenocarcinoma. Definitive surgical therapy was recommended, however, the patient declined surgery in the interest of preserving fertility until November 2006. Final pathology revealed a stage IV, grade 1 endometrioid endometrial cancer.
Conclusion:
Women with endometrial cancer who desire fertility preservation should be counseled regarding the possible risk of advanced disease if surgical therapy is delayed.
