Uterine transposition for fertility preservation in extra-skeletal ewing sarcoma: the first French case report

We present the first French case of uterine transposition for fertility preservation in a 25-year-old nulligravida patient with rectovaginal extra-skeletal Ewing sarcoma. After receiving induction chemotherapy, the uterus was transposed to the upper abdomen via laparotomy. During the same procedure, a posterior pelvectomy was performed to achieve wide surgical margins for tumor removal. To mitigate digestive toxicity from subsequent pelvic radiotherapy, a breast expansion prosthesis was placed. The patient experienced regular menstruation postoperatively, indicating preserved uterine function. After completing radiochemotherapy, we successfully repositioned the uterus into the pelvis. Menstruation resumed within months of reimplantation, and a clinical examination revealed a normal-appearing cervix. This case demonstrates the feasibility and potential benefits of uterine transposition for preserving fertility in women with pelvic malignancies who require radiotherapy. Further research is needed to evaluate the long-term outcomes and reproductive potential of this procedure.