Endometrial carcinoma stage I - Grade II. Conservative treatment followed by a healthy twin pregnancy

Endometrial cancer treatment is commonly based on hysterectomy as the first step, thus creating infertility. This approach troubles the young patient who desires future pregnancies. Hence, the well-known, yet seldom chosen, high-dose progesterone therapy might offer an adequate alternative treatment for a small, carefully selected group of young, early endometrial cancer patients. Presented is a 26-year-old multipara diagnosed, on resectoscopy, with Stage I moderately differentiated carcinoma of the endometrium. Treatment included high dose progesterone and residual disease was ruled out at follow-up. Twin gestation was terminated at term by a cesarean delivery of two healthy babies. We suggest that despite this successful case, this treatment should be offered only to selected patients who desire to preserve their fertility, and for whom close follow-up is possible to monitor the response to progestational therapy. In addition, we believe that at the completion of family planning of these patients, protective hysterectomy should be performed.