Occult myometrial recurrence after progesterone therapy to preserve fertility in a young patient with endometrial cancer

Simon A. Hurst, Kimberly M. Hartzfeld, Giuseppe Del Priore

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: We report a case of endometrial cancer treated by fertility-preserving P therapy, who subsequently presented with an abnormal magnetic resonance imaging (MRI) of the myometrium despite normal endometrial biopsies. Design: Case report. Setting: Tertiary referral university hospital. Patient(s): A 31-year-old patient with grade 1, stage I endometrial cancer presented for treatment with fertility-preserving P therapy. Multiple endometrial samples were all normal. Four years later, she presented with an abnormal pelvic MRI in the absence of any other signs or symptoms. Hysterectomy and oophoropexy confirmed normal endometrium with deeply invasive cancer. She remains cancer-free 2 years later with two normal children from surrogacy. Intervention(s): Progestogen therapy, laparoscopic-assisted vaginal hysterectomy, oophoropexy, and assisted reproductive techniques (ART) and surrogate. Main Outcome Measure(s): Cancer disease status and fertility preservation. Result(s): Eight years after initial diagnosis, the patient remains cancer free and has conceived by surrogate reproductive techniques. Conclusion(s): Reproductive options remains a meaningful quality of life goal even for patients with cancer. Routine pelvic MRI should be considered for follow-up of endometrial cancer patients who retain their uterus. Hysteroscopy and dilation and curettage may not be sufficient.

Original languageEnglish (US)
JournalFertility and Sterility
Volume89
Issue number3
DOIs
StatePublished - Mar 2008
Externally publishedYes

Fingerprint

Endometrial Neoplasms
Progesterone
Fertility
Recurrence
Magnetic Resonance Imaging
Neoplasms
Fertility Preservation
Reproductive Techniques
Therapeutics
Vaginal Hysterectomy
Hysteroscopy
Assisted Reproductive Techniques
Curettage
Myometrium
Progestins
Endometrium
Hysterectomy
Tertiary Care Centers
Signs and Symptoms
Uterus

Keywords

  • dilation and curettage
  • Endometrial cancer
  • hysteroscopy
  • pelvic MRI

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Occult myometrial recurrence after progesterone therapy to preserve fertility in a young patient with endometrial cancer. / Hurst, Simon A.; Hartzfeld, Kimberly M.; Del Priore, Giuseppe.

In: Fertility and Sterility, Vol. 89, No. 3, 03.2008.

Research output: Contribution to journalArticle

Hurst, Simon A. ; Hartzfeld, Kimberly M. ; Del Priore, Giuseppe. / Occult myometrial recurrence after progesterone therapy to preserve fertility in a young patient with endometrial cancer. In: Fertility and Sterility. 2008 ; Vol. 89, No. 3.
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