Nonstandard treatment of endometrial cancer in patient in a procreative age wishing to keep fertility-case report

Agnieszka Kwiatkowska, Dominika Krawczyk, Krzysztof Kułak, Iwona Wertel


Introduction: Endometrial cancer is the most common malignant neoplasm of female reproductive organs that develops from the lining of the womb. The peak incidence falls on the 5th decade of life. Diagnosis of endometrial cancer in young women under 30 years of age is very rare. Detection of cancer at such a young age is an extremely difficult case, because the treatment must consider the reproductive plans of patients so that they can maintain important fertility for them.
Case report: In 2018, a 25-year-old patient was admitted to the Clinic of Oncological Gynaecology and Gynaecology to treat endometrial cancer in FIGO IB. The operation involving the removal of the uterus with fallopian tubes was rejected due to the young age of the patient and her reproductive plans. Prior to hospitalization, the patient was offered the possibility of hormonal treatment that saves fertility. After presenting a 6-month regimen of hormone therapy with medroxyprogesterone acetate (MPA), using a levonorgestrel-releasing intrauterine device, the patient refused consent for its implementation for personal reasons. The patient was proposed to perform electroresection of the endometrial polyp, fractionated erosion of the cavity and cervical canal during hysteroscopy. However, it was marked that it’s possible to not completely remove the cancer during the procedure. The patient agreed to this therapeutic procedure. The procedure was performed without any complications. Quarterly cytological control tests and bi-annual endometrial biopsies are correct and for over a year, there is no recurrence of endometrial cancer and the patient is feeling well.
Conculsion: Electroresection of endometrial changes during hysteroscopy in endometrial cancer can be a promising therapeutic option in the early stages of endometrial cancer (FIGO I) in women who want to maintain fertility. However, this requires further validation. It should be remembered that the occurrence of endometrial cancer at such a young age may be a component of genetic syndromes such as Lynch syndrome. Patient awareness of possible relapses and emphasis on quick response in case of disturbing symptoms is extremely important in order to detect a recurrence as quickly as its possible, and thus extend the patient's life, maintaining its good quality.


Endometrial cancer; Fertility; Conservative treatment

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Cancer Facts and Figures. 2018 (20.08.2019)

Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005 6-12;366(9484):491-505.

Krajowa Baza Danych Nowotworowych. Zakład Epidemiologii i Prewencji Nowotworów Centrum Onkologii – Instytut w Warszawie,

Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108.

Jadoul P, Donnez J. The conservative treatment may be bene cial for young women with atypical endometrial hyperplasia or endometrial adenocarcinoma. Fertil Steril. 2003;80:1315–24.

Digabel JF, Gariel C, Catala L, Dhainaut C, Madelenat P, Descamps P. Hyperplasies atypiques et carcinomes de l’endomètre de stade I chez la femme jeune désirant une grossesse: le traitement conservateur est-il envisageable?. Gynecol Obstet Fertil. 2006;34:27–33.

Benshushan A. Endometrial adenocarcinoma in young patients: evaluation and fertility-preserving treatment. Eur J Obstet Gynecol Reprod Biol. 2004; 117:132–37.

Ota T, Yoshida M, Kimura M, Kinoshita K. Clinicopathologic study of uterine endometrial carcinoma in young women aged 40years and younger. Int J Gynecol Cancer. 2005;15:657–62.

BélièreM,RadikofG,GalantC,PietteP,MarbaixE,DonnezJ.Identi cation of women at high risk of developing endometrial cancer on tamoxifen. Eur J Cancer. 2000;36:35–6.

Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10-17.

Sajdak S, Moszyński R. Rozrosty endometrium – rozpoznawanie i leczenie. W: Sajdak S, Skrzypczak J. (red.) Endometrium. Modulacja, rozwój, zanik. Blackhorse, Warszawa 2004; 8: 65 – 74.

. Bakkum-Gamez JN, Gonzalez-Bosquet J, Laack NN, Mariani A, Dowdy SC. Current issues in the management of endometrial cancer. Mayo Clin Proc. 2008;83(1):97-112.

Martin – Ondarza C, Gil – Moreno A, Torres-Cuesta L, García A, Eyzaguirre F, Díaz-Feijoo B, Xercavins J. Endometrial cancer in polyps: a clinical study of 27 cases. Eur J Gynaecol Oncol. 2005;26(1):55-8.

Kelly P , Dobbs SP , McCluggage WG. Endometrial hyperplasia involving endometrial polyps: report of a series and discussion of the significance in an endometrial biopsy specimen. BJOG. 2007 Aug;114(8):944-50. Epub 2007 Jun 12.

Uterine polyps. (21.08.2019).

Ohkawara S, Jobo T, Sato R, Kuramoto H. Comparison of endometrial carcinoma coexisting with and without endometrial hyperplasia. Eur J Gynaecol Oncol. 2000;21(6):573-7.

Sznurkowski JJ, Knapp P, Bodnar L, et al. Zalecenia Polskiego Towarzystwa Ginekologii Onkologicznej dotyczące diagnostyki i leczenia raka endometrium. Curr Gynecol Oncol. 2017;15:34–44.

Kornafel J, Szelachowska J, Bojarowska K. Rola radioterapii w leczeniu raka błony śluzowej trzonu macicy. W: Markowska J. red. Ginekologia onkologiczna. Elsevier Urban & Partner, Wrocław, 2006. T. 2: 752-758.

Creutzberg CL, van Putten WL, Wárlám-Rodenhuis CC, van den Bergh AC, de Winter KA, Koper PC et al. Outcome of high-risk stage IC, grade 3, compared with stage I endometrial carcinoma patients: the Postoperative Radiation Therapy in Endometrial Carcinoma Trial. J Clin Oncol. 2004 Apr 1;22(7):1234-41.

Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004 Mar;92(3):744-51.

Vaccarello L, Apte SM, Copeland LJ, Boutselis JG, Rubin SC. Endometrial carcinoma associated with pregnancy: a report of three cases and a literature review. Gynecol Oncol. 1999;74:118–22.

De Cherney AH, Desmond MC, Lavy G, Polan ML (1987) Endometrial ablation for intractable uterine bleeding: Hystero- scopic resection. Obstet Gynaecol 78:668–670

Vancaillie TG (1989) Electrocoagulation of the endometrium with the ball-end resectoscope. Obstet Gynaecol 74:425–427

Rutherford AJ, Glass MR (1990) Management of menorrhagia. Br Med J 301:290–291

Serden SP, Brooks PG (1991) Treatment of abnormal uterine bleeding with the gynaecologic resectoscope. J Reprod Med 36:697–699

Ke RW, Taylor PJ (1991) Endometrial ablation to control excessive uterine bleeding. Hum Reprod 6:574–580

Magos AL, Baumann R, Lockwood GM, Turnbull AC (1991) Experience with the first 250 endometrial resection for menorrha- gia. Lancet 334:1074–1078

Dwyer N, Hutton J, Stirrat GM (1993) Randomised trial comparing endometrial resection with abdominal hysterectomy for the surgical treatment of menorrhagia. Br J Obstet Gynaecol 100:237–243

Sculpher MJ, Bryan S, Dwyer N, Hutton J, Stirrat GM (1993) An economic evaluation of transcervical endometrial resection versus abdominal hysterectomy for the treatment of menorrhagia. Br J Obstet Gynaecol 100:244–252

Broadbent JA, Magos AL (1993) Transcervical resection of the endometrium (TRCE). In: Sutton C, Diamond MP (ed) Endoscopic Surgery for Gynaecologists. WB Sauders, London, pp 294–300

Pinion SB, Parkin DE, Abramovich DR (1994) Randomised trial of hysterectomy, endometrial laser-ablation and transcervical endometrial resection for dysfunctional uterine bleeding. Br Med J 309:979–983

Garry R (1995) Good practice with endometrial ablation. Obstet Gynaecol 86:144–151

Raiga J, Mage G, Glowaczower E (1995) Factors affecting risk of failure after endometrial resection. J Gynecol Surg 11:1–6

Gaia G., Botchorishvili R., Canis M., et al: Endometrial cancer following endometrial resection. Gynecol Surg 2007; 4: pp. 179-185

Chiva L, Lapuente F, Gonzalez-Cortijo L, et al. Sparing fertility in young patients with endometrial cancer. Gynecol Oncol. 2008;111:101–4.



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