Gil González Yolanda, Pérez Morales María Elena, Emergi Zhrigen Yonit, Santana Suárez María Alejandra, Pérez Matos Cristina, Nieto Naya María Ángeles, Ocón Padrón Ludmila, Laseca Modrego María, Arencibia Sánchez Octavio, Sánchez Sánchez Victoria, Martín Martínez Alicia Inmaculada
Complejo Hospitalario Universitario Insular Materno Infantil-Las Palmas de Gran Canaria, Las Palmas, Spain.
J Obstet Gynaecol. 2022 Nov;42(8):3435-3440. doi: 10.1080/01443615.2022.2152656.
Twenty-five percent of cases of endometrial cancer appear in women with unfulfilled reproductive desires An adequate selection of patients and a close hysteroscopic follow-up to monitor the endometrial response to the levonorgestrel-releasing intrauterine system (LNG-IUS) may be a valid and safe option for these patients This is a case series and review of the literature study. We included eight patients diagnosed of complex endometrial hyperplasia with atypia (CEHA) or stage 1AG1 well-differentiated endometrial cancer without myometrial invasion who desired to get pregnant and opted for a conservative treatment. Follow-up was performed with hysteroscopy and directed biopsy at 3, 6 and 12 months. Of the 854 cases of complex endometrial hyperplasia with atypia (CEHA)/endometrial cancer were diagnosed, 2.3% were candidates for conservative management. We obtained a favourable regression of 71.2% at 6 months and 57% at one year with hormonal treatment. Conservative treatment in complex endometrial hyperplasia with atypia (CEHA)/low-grade endometrial cancer in reproductive age patients with a strong desire for pregnancy is feasible.
25%的子宫内膜癌病例出现在有未实现生育愿望的女性中。对于这些患者，充分选择合适的患者并进行密切的宫腔镜随访以监测子宫内膜对左炔诺孕酮宫内节育系统（LNG-IUS）的反应可能是一种有效且安全的选择。这是一项病例系列及文献综述研究。我们纳入了8例被诊断为复杂性非典型子宫内膜增生（CEHA）或1AG1期高分化子宫内膜癌且无肌层浸润、希望怀孕并选择保守治疗的患者。在3、6和12个月时通过宫腔镜检查和定向活检进行随访。在854例复杂性非典型子宫内膜增生（CEHA）/子宫内膜癌病例中，2.3%适合保守治疗。通过激素治疗，6个月时获得了71.2%的良好消退率，1年时为57%。对于有强烈怀孕愿望的育龄期患者，对复杂性非典型子宫内膜增生（CEHA）/低级别子宫内膜癌进行保守治疗是可行的。
