Lombardi Fäh Valeria, Del Vento Federico, Intidhar Labidi-Galy S, Undurraga Manuela
Division of Gynecology, Department of Pediatrics and Gynecology, Hôpitaux Universitaires de Genève, Genève, Switzerland.
Department of Oncology, Hôpitaux Universitaires de Genève, Genève, Switzerland.
Gynecol Oncol Rep. 2024 Oct 15;56:101531. doi: 10.1016/j.gore.2024.101531. eCollection 2024 Dec.
Fertility preservation (FP) is an important aspect of the treatment of young women diagnosed with serous borderline ovarian tumors (SBOT), with fertility sparing surgery recommended when possible. Concurrent treatment with aromatase inhibitor letrozole during ovarian stimulation (OS) could be used in women with hormone-sensitive breast cancer, but very little is known in gynecological tumors. Here, we report the cases of 2 young nulliparous women with early stage SBOT who underwent successful OS with letrozole. Patient 1 is 22-years old, FIGO IIB. She had a bilateral ovarian recurrence 5 months after the first surgery. She underwent OS with letrozole (four oocytes were collected and vitrified), followed by cytoreduction. The patient is in complete remission since 2 years. Patient 2 is 27-years old, FIGO IC3, treated by right adnexectomy. Ten months after surgery, she was in complete remission. OS with letrozole was performed and 4 oocytes were retrieved, resulting in 2 blastocysts that were cryopreserved. She had a successful pregnancy after in-vitro fertilization. She underwent a delivery via C-Section for obstetrical reasons that revealed a macroscopic suspicious lesion on the left ovary. Cystectomy was performed during C-section, confirming tumor recurrence. She underwent a second pregnancy uneventfully. During the second C-section, a partial cystectomy and multiples peritoneal biopsies were performed revealing tumor recurrence limited to the left ovary. She underwent left adnexectomy two months after C-Section without any recurrence. In conclusion, our case report described successful oocytes cryopreservation, without changes in the appearance of ovarian cysts, in nulliparous women with early-stage SBOT who underwent OS with simultaneous administration of letrozole.
生育力保存（FP）是诊断为浆液性交界性卵巢肿瘤（SBOT）的年轻女性治疗的一个重要方面，尽可能推荐保留生育功能的手术。在卵巢刺激（OS）期间，芳香化酶抑制剂来曲唑可用于激素敏感性乳腺癌女性，但在妇科肿瘤方面了解甚少。在此，我们报告2例早期SBOT的未生育年轻女性成功使用来曲唑进行卵巢刺激的病例。患者1为22岁，国际妇产科联盟（FIGO）IIB期。她在首次手术后5个月出现双侧卵巢复发。她接受了来曲唑卵巢刺激（收集并玻璃化了4个卵母细胞），随后进行了肿瘤细胞减灭术。该患者自2年前起完全缓解。患者2为27岁，FIGO IC3期，接受了右侧附件切除术。手术后10个月，她完全缓解。进行了来曲唑卵巢刺激，获取了4个卵母细胞，得到2个冷冻保存的囊胚。她在体外受精后成功怀孕。因产科原因行剖宫产分娩，术中发现左卵巢有一个肉眼可疑病变。剖宫产时进行了囊肿切除术，证实为肿瘤复发。她顺利进行了第二次怀孕。在第二次剖宫产时，进行了部分囊肿切除术和多处腹膜活检，发现肿瘤复发仅限于左卵巢。剖宫产术后2个月，她接受了左侧附件切除术，无任何复发。总之，我们的病例报告描述了早期SBOT未生育女性在同时使用来曲唑进行卵巢刺激时成功冷冻卵母细胞，且卵巢囊肿外观无变化。
