Successful Pregnancy After Fertility-Sparing Local Resection and Uterine Reconstruction for Low-Grade Endometrial Stromal Sarcoma

Delaney, Abigail A.; Gubbels, Ashley L.; Remmenga, Steven W.; Tomich, Paul G.; Molpus, Kelly L.

doi:10.1097/aog.0b013e31825a7397

Cited by 25 publications

(28 citation statements)

References 5 publications

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“…Considering relative indolent course and better prognosis of low‐grade ESS, fertility‐preserving treatment might be possible. Fertility‐sparing surgery for young women with ESS has been reported in a few case reports . Some achieved successful pregnancies, while others ended up recurrences.…”

Section: Introductionmentioning

confidence: 99%

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Chin

Lin

et al. 2018

J of Obstet and Gynaecol

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Considering the characteristics of low-grade endometrial stromal sarcoma (ESS), such as relative indolent course, younger age at diagnosis and favorable prognosis, the fertility-preserving management of low-grade ESS has been described by several authors. We report a 34-year-old female with stage IB low-grade ESS who developed recurrence 7 years after neoadjuvant high-dose progestin therapy followed by fertility-preserving surgery and postoperative progestin therapy. The patient stopped progestin therapy and was disease free for 4 years after diagnosis but experienced recurrence with peritoneal dissemination at 7 years. Considering the tendency of late recurrence, long-term surveillance is necessary to ensure timely action. Long-term progestin treatment might be considered after complete remission even beyond 5 years. We performed a literature review and found that many of the cases did not meet solid pathological criteria of low-grade ESS. The diagnostic criteria of low-grade ESS (vs endometrial stromal nodule) should be deliberately documented for future studies of this rare disease.

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Section: Introductionmentioning

confidence: 99%

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Chin

Lin

et al. 2018

J of Obstet and Gynaecol

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“…However, fertility‐sparing management is sometimes attempted for nulliparous young women, although the success of conservative management is unclear. Several ‘successful’ cases of the uterus being preserved after diagnosis of ESS have been reported after a short follow‐up period . Here, we report a fatal case after long‐term follow‐up.…”

Section: Introductionmentioning

confidence: 84%

“…Only three delivery cases after conservative management for ESS have been reported . One of these three patients underwent TCR, and conceived after 6 months.…”

Section: Discussionmentioning

confidence: 99%

Fatal case of multiple recurrences of endometrial stromal sarcoma after fertility‐sparing management

Morimoto

Taniguchi

Inoue

et al. 2014

J of Obstet and Gynaecol

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Several cases of the uterus being preserved after diagnosis of endometrial stromal sarcoma (ESS) have been reported. Most of these patients were alive and did not experience relapse, but this might have reflected the short follow-up period, given the indolent recurrence of ESS. We report the first fatal case of ESS 10 years after fertility-sparing management. A specimen obtained from the last operation showed loss of estrogen receptor status and expression of c-kit without c-kit or PDGFR-α gene mutations.

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“…Indeed, fertility-preserving surgery in young nulliparous females had been proposed in several cases (2–5) and successful pregnancy following such management had been reported, shown in detail in Table I (2,3). For patients who present with a confined uterus mass and no signs of tumor metastasis or infiltration, it is, in theory, feasible to preserve the patient’s uterus.…”

Section: Discussionmentioning

confidence: 99%

“…In general, ESS occurs in perimenopausal and postmenopausal females (2,3), and <25% of ESS patients are premenopausal (4). The mainstay of treatment for ESS is total hysterectomy and bilateral salpingo-oophorectomy, and adjuvant treatments include chemotherapy, radiation and endocrine therapy.…”

Section: Introductionmentioning

confidence: 99%

Successful pregnancy following conservative management of low-grade endometrial stromal sarcoma: A case report

et al. 2014

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It is uncommon that fertility is preserved in young nulliparous females with low-grade endometrial stromal sarcoma (ESS). Therefore, successful pregnancy following such conservative management has been rarely reported in previous literature. A 25-year-old female (gravida, 0; para, 0) underwent hysteroscopic surgery and was pathologically diagnosed with an endometrial stromal nodule. The patient underwent fertility-preserving local resection and uterine reconstruction, with a final pathological diagnosis of low-grade ESS. Endocrine therapy was then administered. Conservative management resulted in the complete remission of low-grade ESS. The patient naturally conceived and successfully delivered a healthy baby at 42 weeks’ gestation by cesarean section, ~30 months following diagnosis with low-grade ESS. In conclusion, conservative management, including fertility-preserving local mass resection and endocrine therapy, can be effective for low-grade ESS and may yield a favorable outcome for young nulliparous females desiring fertility preservation.

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Successful Pregnancy After Fertility-Sparing Local Resection and Uterine Reconstruction for Low-Grade Endometrial Stromal Sarcoma

Abstract: Fertility-sparing management and close follow-up of low-grade endometrial stromal sarcoma may be a viable option for those desiring future fertility.

Cited by 25 publications

References 5 publications

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Fatal case of multiple recurrences of endometrial stromal sarcoma after fertility‐sparing management

Successful pregnancy following conservative management of low-grade endometrial stromal sarcoma: A case report

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