Introduction/Background Fertility preservation approach is used in stage 2 endometrioid endometrial cancer patients with P53 mutation who desire pregnancy. As per literature, there is a lack of consensus on the treatment method used for these patients.
Methodology This is a case study conducted at 19 May University in 2023, which describes the fertility preservation approach in patients with P53 mutant grade 2 endometrioid endometrial cancer.
Results A 35-year-old patient presented with a desire for pregnancy, and the endometrial biopsy result showed endometrioid adenocarcinoma (FIGO grade 1). The endometrial biopsy previously performed in an external center was re-examined and POLE mutation was found to be negative. P53 was positively stained, and low-grade endometrial endometrioid carcinoma (FIGO grade 2) was detected. Contrasted MRI of the lower abdomen did not reveal myometrial invasion or metastasis. The patient used Megestrol acetate 160 mg for 3 months. During the first follow-up, dilatation and curettage were used instead of hysteroscopy due to the tumor size. The endometrial biopsy taken showed no invasive tumor focus, and progesterone-induced endometrium was detected. The patient was closely monitored and continued to use Megestrol acetate 160 mg for another 3 months. In the second follow-up, hysteroscopy revealed irregular and thickened endometrium. Endometrial biopsy was taken from the anterior, posterior, and lateral walls of the uterus, and the results showed atypical endometrial hyperplasia and endometrial polyp. The patient was monitored for 2 more months, and a follow-up ultrasound showed an increase in endometrial thickness. Hysterectomy was suggested to the patient after risk-sharing. Following the procedure, the pathology report showed low-grade endometrial endometrioid carcinoma (FIGO grade 2).
Conclusion Fertility-preserving approaches can be considered as a rare option for P53 Mutant Grade2 endometrioid endometrial cancer patients. However, as seen in our case, despite close monitoring, disease progression has been observed.
Disclosures There is no conflict of interest in this statement.
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