A successful live twin birth by in vitro fertilization after conservative treatment of recurrent endometrial cancer.
Endometrial cancer is predominately a postmenopausal disease. Endometrial cancer in women of childbearing age is relatively unusual. Endometrial cancer is typically treated with hysterectomy. After the development of endometrial cancer, successful pregnancy is rare. We present a case of recurrent stage I endometrial adenocarcinoma in a 35-year-old woman. Magnetic resonance imaging (MRI) revealed endometrial lesions without myometrium invasion and no pelvic lymph node enlargement. The patient refused surgical intervention with abdominal hysterectomy and bilateral salpingo-oophorectomy because of her essential desire for children. Fertility-preserving medical therapy with megestrol acetate for 1 year and subsequent assisted reproductive treatment (ART) were performed. Successful pregnancy occurred after in vitro fertilization-embryo transfer (IVF-ET). On the basis of these observations and the low malignant potential of well-differentiated endometrial carcinoma, fertility-preserving treatment using Megace therapy was suggested. In this case, recurrence occurred after the completion of Megace therapy and three failed attempts at artificial insemination by the husband (AIH). Recurrent endometrial adenocarcinoma was documented using hysteroscopy and direct endometrial biopsy. Another course of Megace therapy was administered due to her desire for children. A successful pregnancy occurred after long-term medical treatment and IVF-ET.
Wu
Hsien-Ming
HM
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Chang Gung University College of Medicine, Gueishan Township, Taoyuan, Taiwan, ROC.
Lai
Chyong-Huey
CH
Huang
Hong-Yuan
HY
Wang
Hsin-Shih
HS
Soong
Yung-Kuei
YK
D000230:Adenocarcinoma / Q000188:drug therapy*; D000328:Adult; D016889:Endometrial Neoplasms / Q000188:drug therapy*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D050498:Live Birth; D019290:Megestrol Acetate / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D014427:Twins
D019290:Megestrol Acetate