title: Occult myometrial recurrence after progesterone therapy to preserve fertility in a young patient with endometrial cancer.
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.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Tertiary referral university hospital.
  
  
  METHODS
  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.
  
  
  METHODS
  Progestogen therapy, laparoscopic-assisted vaginal hysterectomy, oophoropexy, and assisted reproductive techniques (ART) and surrogate.
  
  
  METHODS
  Cancer disease status and fertility preservation.
  
  
  RESULTS
  Eight years after initial diagnosis, the patient remains cancer free and has conceived by surrogate reproductive techniques.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Imperial College School of Medicine, Westminster Hospital, London, United Kingdom.
authors.forename: Simon A
authors.initials: SA
authors.lastname: Hurst
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Hartzfeld
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Priore
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005298:Fertility; D006801:Humans; D007045:Hysterectomy, Vaginal; D015907:Hysteroscopy; D007247:Infertility, Female / Q000503:physiopathology / Q000517:prevention & control*; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D019290:Megestrol Acetate / Q000627:therapeutic use*; D009215:Myometrium / Q000473:pathology* / Q000601:surgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010052:Ovariectomy; D011247:Pregnancy; D011372:Progestins / Q000627:therapeutic use*; D011788:Quality of Life; D027724:Reproductive Techniques, Assisted; D013533:Gestational Carriers; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011372:Progestins; D019290:Megestrol Acetate