title: Incidental endometrial carcinoma diagnosed at first trimester pregnancy loss: a case report.
abstract: BACKGROUND
  All cases reported to date of endometrioid endometrial adenocarcinoma (EEA) associated with pregnancy have been treated surgically or medically. We describe a case of EEA in pregnancy that was managed expectantly, allowing for observation of the natural course of the disease.
  
  
  METHODS
  A 36-year-old woman, gravida 2 para 1, presented at eight weeks of pregnancy with heavy vaginal bleeding. Ultrasound assessment confirmed a missed abortion, and the patient underwent dilatation and curettage. Tissue pathology primarily suggested grade 1 EEA. The patient chose expectant management. Eight months later, she returned with vaginal bleeding. Hysterectomy was performed and the hysterectomy specimen showed FIGO grade 1 stage 1A EEA.
  
  
  CONCLUSIONS
  Treating EEA associated with pregnancy is challenging. Our experience in the case described here suggests that expectant management should not be undertaken due to a high risk of recurrence.
authors.affiliation: University of Ottawa, Ottawa ON; The Ottawa Hospital, Ottawa ON.
authors.forename: Lana
authors.initials: L
authors.lastname: Saciragic
authors.affiliation: University of Ottawa, Ottawa ON; The Ottawa Hospital, Ottawa ON.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Ball
authors.affiliation: University of Ottawa, Ottawa ON; The Ottawa Hospital, Ottawa ON.
authors.forename: Shahidul
authors.initials: S
authors.lastname: Islam
authors.affiliation: University of Ottawa, Ottawa ON; The Ottawa Hospital, Ottawa ON.
authors.forename: Michael
authors.initials: M
authors.lastname: Fung-Kee-Fung
mesh_terms: D000022:Abortion, Spontaneous / Q000601:surgery*; D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D033162:Incidental Findings; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000601:surgery; D011261:Pregnancy Trimester, First
keywords: abortion; endometrial carcinoma; fertility sparing; products of conception