title: Bariatric Surgery: Does It Play a Role in Fertility-Preserving Treatment Among Obese Young Women With Endometrial Cancer?
abstract: We present the case of a 17-year-old nulliparous woman with a history of obesity (body mass index 36.2 kg/m(2)), type 2 diabetes, and polycystic ovary syndrome, who was diagnosed with grade 1 endometrioid adenocarcinoma without radiological evidence of myometrial invasion or metastatic disease. After failure of a fertility-preserving treatment with a levonorgestrel-releasing intrauterine device, bariatric surgery was proposed to treat the obesity and improve control of her type 2 diabetes in an attempt to increase the chances of obtaining response to local treatment. Nine months after laparoscopic sleeve gastrectomy and 18 months after insertion of the intrauterine device, the patient reached normal body weight (body mass index 20.3 kg/m(2)) and showed complete response to treatment. As far as we know, this is the first published case of an adolescent obese patient treated with bariatric surgery concomitantly with fertility-preserving management of endometrial cancer. We propose that bariatric surgery may play a role as an adjuvant therapy in fertility-preserving treatment of endometrial cancer with local progestin, in which it could enhance remission rates and reduce recurrence.
authors.affiliation: Department of Gynaecology Oncology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain. Electronic address: virginia.benito@yahoo.es.
authors.forename: Virginia
authors.initials: V
authors.lastname: Benito
authors.affiliation: Department of Surgery, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: Eudaldo
authors.initials: E
authors.lastname: López-Tomassetti
authors.affiliation: Department of Gynaecology Oncology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: Miriam
authors.initials: M
authors.lastname: Esparza
authors.affiliation: Department of Gynaecology Oncology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: Octavio
authors.initials: O
authors.lastname: Arencibia
authors.affiliation: Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Andújar
authors.affiliation: Department of Gynaecology Oncology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Prieto
authors.affiliation: Department of Gynaecology Oncology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: Amina
authors.initials: A
authors.lastname: Lubrano
mesh_terms: D000293:Adolescent; D050110:Bariatric Surgery; D018269:Carcinoma, Endometrioid / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D003271:Contraceptive Agents, Female; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D007434:Intrauterine Devices; D016912:Levonorgestrel / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009765:Obesity / Q000150:complications / Q000601:surgery*; D011085:Polycystic Ovary Syndrome; D016896:Treatment Outcome
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: Bariatric surgery; Endometrial cancer; Fertility-preserving treatment; Obesity