Tanmahasamut Prasong, Wongwananuruk Thanyarat
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Case Rep Oncol. 2010 Oct 25;3(3):380-385. doi: 10.1159/000321731.
A 20-year-old obese Thai woman with polycystic ovary syndrome and clinical stage I well-differentiated endometrial carcinoma denied surgical staging. Chest X-ray and magnetic resonance imaging of the whole abdomen suggested neither distance metastasis nor local invasion of the cancer. After 3 months of systemic progestin therapy with megestrol acetate (MA) 480 mg/day, the endometrial carcinoma persisted. The treatment was changed to a combination of levonorgestrel intrauterine system (LNG-IUS) and MA with a stepping-up from 160 to 480 mg/day. Complete remission was achieved at treatment month 9. Prevention of recurrence was provided using LNG-IUS plus MA 160 mg/day. Endometrial surveillance using trimonthly transvaginal ultrasonography and endometrial biopsy suggested no recurrence for at least 24 months after remission.
一名20岁的肥胖泰国女性，患有多囊卵巢综合征及临床I期高分化子宫内膜癌，拒绝接受手术分期。胸部X光及全腹磁共振成像检查均未提示癌症有远处转移或局部侵犯。在接受每日480毫克醋酸甲地孕酮（MA）进行3个月的全身孕激素治疗后，子宫内膜癌仍持续存在。治疗方案改为左炔诺孕酮宫内节育系统（LNG-IUS）联合MA，MA剂量从每日160毫克逐步增至480毫克。在治疗第9个月时实现了完全缓解。采用LNG-IUS加每日160毫克MA预防复发。每三个月进行经阴道超声检查及子宫内膜活检的子宫内膜监测提示，缓解后至少24个月无复发。
