Well-differentiated endometrial adenocarcinoma in an infertility patient with later conception - A case report

BACKGROUND: The incidence of well-differentiated endometrial adenocarcinoma in reproductive-age women is approximately 5%. When the woman desires to r etain her future fertility in light of this diagnosis, choices of surgery v s. medical therapy may present a dilemma for both the physician and patient . CASE: A young infertility patient with well-differentiated endometrial aden ocarcinoma conceived by ovulation induction and intrauterine insemination a fter medical therapy. She subsequently delivered vaginally, and follow-up d ilatation and curettage revealed no evidence of recurrent carcinoma. CONCLUSION: This case illustrates that with close observation by endometria l sampling for histologic diagnosis and follow-trp, medical therapy can be an option for treating this condition to allow future fertility. The patien t must be extensively counseled, however, concerning the nearly 33% chance of progression or recurrence of disease. One must also stress the importanc e of frequent evaluation of symptoms and endometrial pathology postpartum, with endometrial sampling as indicated and discussion of definitive surgica l therapy once fertility is no longer desired.