Endometrial carcinoma remaining after term pregnancy following conservative treatment with medroxyprogesterone acetate

Background. Successful pregnancies after conservative progestin treatment t o young women with endometrial carcinoma have recently been reported. Howev er, it is not known for certain whether the lesion is completely eradicated in such patients. We present a case of residual endometrial carcinoma afte r term pregnancy which had been treated conservatively before the pregnancy began. Case. A 28-year-old woman with endometrial carcinoma received conservative treatment with high-dose medroxyprogesterone acetate (MPA) and then conceiv ed. After delivery at term, atypical cells were found in the endometrial cu rettage specimen. A hysterectomy was performed 6 months after delivery and revealed the presence of a small focus of intramucosal, grade I, endometrio id-type adenocarcinoma. Immunohistochemically, the tumor cells were positiv e for estrogen and progesterone receptors. Conclusion. We concluded that while MPA treatment had been effective, it ha d not completely eradicated the carcinomatous lesion, which remained during and after the term pregnancy. (C) 2000 Academic Press.