Sodano M, Bogliatto F, Morero S, Mosso L, Torchio B, Leidi L
CMR, Reproductive Medicine Centre, Turin, Italy.
Reprod Biomed Online. 2009 Apr;18(4):578-81. doi: 10.1016/s1472-6483(10)60137-x.
Some cases of successful pregnancy after conservative endometrial cancer management have been reported. This paper presents such a case, an infertile patient with conservatively treated endometrial cancer (stage 1a grade 1) who conceived and carried a successful pregnancy after IVF treatment. The conservative treatment consisted of hysteroscopic biopsies and oral megestrol acetate 600 mg daily for 3 months. At the end of the treatment the endometrial cancer remitted to simple endometrial hyperplasia. IVF was performed immediately and 32 days after embryo transfer an intrauterine single gestational sac with fetal pole and heartbeat was detected by transvaginal ultrasound. The woman received routine obstetric care and a caesarean section was performed at 38 weeks of gestation. The histological evaluation after delivery showed no evidence of recurrent disease. Twenty-six months after the delivery, the woman is healthy and free of the disease. It is concluded that conservative treatment of stage 1a and grade 1 endometrial adenocarcinoma is an available option in young women who wish to preserve their fertility.
已有报道称部分子宫内膜癌患者经保守治疗后成功妊娠。本文介绍了这样一个病例,一名患有经保守治疗的子宫内膜癌(1a期1级)的不孕患者,在接受体外受精(IVF)治疗后成功受孕并顺利分娩。保守治疗包括宫腔镜活检以及每日口服600毫克醋酸甲地孕酮,持续3个月。治疗结束时,子宫内膜癌缓解为单纯性子宫内膜增生。随即进行了体外受精,胚胎移植32天后,经阴道超声检测到宫内有一个带有胎芽和心跳的单妊娠囊。该名女性接受了常规产科护理,并在妊娠38周时进行了剖宫产。产后的组织学评估显示没有复发疾病的迹象。分娩26个月后,该名女性身体健康,未患疾病。结论是,对于希望保留生育能力的年轻女性,1a期1级子宫内膜腺癌的保守治疗是一种可行的选择。