title: Stage IV endometrial cancer after failed conservative management: a case report.
abstract: BACKGROUND
  With younger women becoming increasingly overweight, endometrial cancer is becoming a concern in this group. These women are likely to desire fertility preservation. There are no randomized controlled data to guide conservative therapy.
  
  
  METHODS
  A 24-year-old female with endometrial adenocarcinoma diagnosed in December 2003 was treated conservatively with Megace and levonorgestrel intrauterine device. She was lost to follow-up and represented in March 2006. Endometrial biopsy revealed grade 1 endometrial adenocarcinoma. Definitive surgical therapy was recommended, however, the patient declined surgery in the interest of preserving fertility until November 2006. Final pathology revealed a stage IV, grade 1 endometrioid endometrial cancer.
  
  
  CONCLUSIONS
  Women with endometrial cancer who desire fertility preservation should be counseled regarding the possible risk of advanced disease if surgical therapy is delayed.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Medical Center, Columbus, OH 43210, USA. rajul.kothari@osumc.edu
authors.forename: Rajul
authors.initials: R
authors.lastname: Kothari
authors.forename: Leigh
authors.initials: L
authors.lastname: Seamon
authors.forename: David
authors.initials: D
authors.lastname: Cohn
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fowler
authors.forename: David M
authors.initials: DM
authors.lastname: O'Malley
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery*; D000328:Adult; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D017211:Treatment Failure; D055815:Young Adult