Introduction: This is the second report on the conservative treatment of endometrial carcinoma in a female patient younger than fifteen years. Case A, a 14-year-old teenager, presented with menorrhagia. An endometrial biopsy revealed grade 2 endometrioid adenocarcinoma. The estrogen receptor and progesterone receptor were strongly positive in 60% and 90% of the tumor, respectively. Although she was administered medroxyprogesterone acetate for a month, it was not effective. She underwent standard surgery including a hysterectomy. She was thereafter free of disease 1 year after surgery. No estrogen receptor staining of the surgical specimen was observed, and 30% of the tumor was strongly positive for progesterone receptor. Direct DNA sequencing of exons 7 and 8 of PTEN and the K-ras codon 12 demonstrated the presence of no mutation. In addition, no dominant-negative p53 mutation was found by a yeast functional assay.

Conclusion: A uterine malignancy should therefore be included in the differential diagnosis in a young female patient complaining of abnormal genital bleeding.