Successful pregnancy in women with endometrial carcinoma

Abstract

Endometrial cancer is the sixth most common cancer in women worldwide and fourth in Europe. Global estimates show rising incidence in both developed and developing countries. Standard surgical treatment leads to permanent loss of fertility. With current trends of reproductive-age women delaying childbearing, rising endometrial carcinoma incidence rates and a growing epidemic of obesity, research on conservative treatment remains a priority. Fertility-sparing treatment involves the use of oral progestins and levonorgestrel-releasing intrauterine devices, both shown to be beneficial and safe in early-stage endometrial carcinoma. We present a case of a 40-year-old female with endometrial adenocarcinoma grade 1 diagnosed during infertility workup. After one year of levonorgestrel-releasing intrauterine devices and almost three years after initial diagnosis was made, pregnancy was achieved. Term elective C-section delivery was done and a healthy infant was born. Today, a 46-yearold female, with six years of disease-free survival, still opts for conservative treatment. Aim of this paper is to show how conservative management with steady follow up in highly motivated individuals could be a reliable option for females of reproductive age with endometrial malignancies. Concept of fertility-sparing treatment should give hope to patients with malignant disease and unfulfilled reproductive goals.

Keywords

• endometrial carcinoma
• fertility-sparing treatment
• assisted reproductive technology