Absence of progesterone receptors in a failed case of fertility-sparing treatment in early endometrial cancer: a case report.
BACKGROUND
Fertility-sparing treatment may be offered as an alternative to standard surgical management of early-stage, well-differentiated endometrial cancer in young women. Immunostaining for progesterone receptor (PR) status is not currently part of the standard workup before treatment recommendations are made.


METHODS
We describe a 29-year-old woman who used oral contraceptive pills on a long-term basis in whom early-stage, well-differentiated endometrial cancer was diagnosed. Progestin therapy failed and the tumor was subsequently found to be PR negative.


CONCLUSIONS
Combination oral contraceptive pills may stimulate clonal expansion of endometrial cells that lack PR, leading to endometrial adenocarcinoma unresponsive to progestin therapy. Consideration should be given to PR immunostaining for confirmation of the receptor status and evaluation of appropriate management options when counseling patients about fertility-sparing therapy.
Hoekstra
Anna V
AV
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, USA. annahoekstra@sbcglobal.net
Kim
J Julie
JJ
Keh
Pacita
P
Schink
Julian C
JC
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D019008:Drug Resistance, Neoplasm; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008535:Megestrol / Q000627:therapeutic use; D045167:Progesterone Congeners / Q000009:adverse effects*; D011980:Receptors, Progesterone / Q000032:analysis*
D018931:Antineoplastic Agents, Hormonal; D003278:Contraceptives, Oral, Hormonal; D045167:Progesterone Congeners; D011980:Receptors, Progesterone; D008535:Megestrol