Stage IV endometrial cancer after failed conservative management: A case report

BackgroundWith younger women becoming increasingly overweight, endometrial cancer is becoming a concern in this group. These women are likely to desire fertility preservation. There are no randomized controlled data to guide conservative therapy.CaseA 24-year-old female with endometrial adenocarcinoma diagnosed in December 2003 was treated conservatively with Megace and levonorgestrel intrauterine device. She was lost to follow-up and represented in March 2006. Endometrial biopsy revealed grade 1 endometrial adenocarcinoma. Definitive surgical therapy was recommended, however, the patient declined surgery in the interest of preserving fertility until November 2006. Final pathology revealed a stage IV, grade 1 endometrioid endometrial cancer.ConclusionWomen with endometrial cancer who desire fertility preservation should be counseled regarding the possible risk of advanced disease if surgical therapy is delayed.