Fertility therapy in the setting of a history of invasive epithelial ovarian cancer.
A link between fertility drugs and epithelial ovarian cancer has been suggested by at least one case-control study, and by multiple case reports of such tumors developing following fertility drug therapy. We report the case of a woman with stage IC grade 1 mucinous epithelial ovarian cancer who died of recurrent disease shortly after receiving gonadotropin therapy for ovulation induction. The patient was initially treated with a staging procedure, unilateral salpingo-oophorectomy, and 3 courses of cytoxan and carboplatinum. Over the next 3 years she underwent 2 cycles of ovulation induction with exogenous gonadotropins. Five months after the second cycle, the patient presented with a bowel obstruction and extensive recurrence of disease. Two months later she died despite extensive surgical debulking, and cis-platinum and Taxol chemotherapy. Although a causal relationship between fertility therapy and ovarian cancer has not been established, this case report suggests ovulation induction may be inadvisable in a woman with a prior diagnosis of invasive epithelial ovarian cancer.
Bandera
C A
CA
Division of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Cramer
D W
DW
Friedman
A J
AJ
Sheets
E E
EE
D002288:Adenocarcinoma, Mucinous / Q000139:chemically induced*; D000328:Adult; D005260:Female; D006062:Gonadotropins / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy; D009364:Neoplasm Recurrence, Local / Q000139:chemically induced*; D010051:Ovarian Neoplasms / Q000139:chemically induced*; D010062:Ovulation Induction
D006062:Gonadotropins