title: Fertility-sparing management combined with photodynamic therapy for endometrial stromal sarcoma: a case report.
abstract: OBJECTIVE
  Low-grade endometrial sarcoma (LGESS) has a favorable prognosis after standard surgical treatment. The conservative fertility-sparing treatments in young patients with LGESS have been reported; however, the role of conservative therapy is not well defined.
  
  
  METHODS
  A 31-year-old nulliparous woman was diagnosed with LGESS after resection of a cervical polyp with resection margin positive for malignancy. She underwent fertility-sparing surgery including laparoscopic pelvic lymph node dissection, hysteroscopic endometrial polypectomy, endocervical curettage, and photodynamic therapy (PDT) on the endometrium and uterine cervix. And she had received adjuvant therapy with a non-steroidal aromatase inhibitor.
  
  
  RESULTS
  She conceived by in vitro fertilization and delivered twins at 32+2 weeks gestation by Cesarean section 32 months after conservative treatment. She has no evidence of recurrence after 99 months of follow-up.
  
  
  CONCLUSIONS
  Conservative management of LGESS may be attempted in selected patients who want to preserve fertility. Conservative surgery combined with PDT has shown effective results in long-term follow-up.
authors.affiliation: Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Choi
authors.affiliation: Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors.forename: Gwangil
authors.initials: G
authors.lastname: Kim
authors.affiliation: Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea. Electronic address: oursk@hanmail.net.
authors.forename: Yoon Young
authors.initials: YY
authors.lastname: Hwang
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000517:prevention & control*; D059351:Organ Sparing Treatments / Q000379:methods*; D010778:Photochemotherapy / Q000379:methods*; D011832:Radiation Injuries / Q000517:prevention & control*; D018203:Sarcoma, Endometrial Stromal / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
keywords: Endometrial stromal sarcoma; Fertility sparing; Photodynamic therapy