Ovarian metastasis in a nulliparous woman with endometrial adenocarcinoma failing conservative hormonal treatment.
BACKGROUND
There have been several reports about successful fertility-preserving treatment of endometrial carcinoma with subsequent pregnancy. However, conservative hormonal treatment for early-stage endometrial cancer still entails some risk.


METHODS
We present a 36-year-old nulliparous woman, initially diagnosed as clinical stage IA, grade 1 endometrial adenocarcinoma, receiving 6-month conservative treatment with remission achieved at 4 months from diagnosis. Recurrence at the endometrium was documented at the end of treatment. She underwent a definitive surgery including total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. The final pathology revealed well-differentiated endometrioid adenocarcinoma with inner one-third myometrial invasion and right ovarian metastasis.


CONCLUSIONS
This case report signals a warning that negative preoperative imaging studies are not reassuring for a relapsing low-grade, early-stage endometrial carcinoma failing conservative treatment.
Huang
Shih-Yin
SY
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University, 5 Fu-Shin St., Kueishan, Taoyuan 333, Taiwan.
Jung
Shih-Ming
SM
Ng
Koon-Kwan
KK
Chang
Yu-Chen
YC
Lai
Chyong-Huey
CH
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D000328:Adult; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D019290:Megestrol Acetate / Q000627:therapeutic use*; D010051:Ovarian Neoplasms / Q000556:secondary* / Q000601:surgery
D019290:Megestrol Acetate