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

Abstract

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.

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

“…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.…”

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

“…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.…”

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

“…Only three delivery cases after conservative management for ESS have been reported. [2][3][4][5] One of these three patients underwent TCR, and conceived after 6 months. She had a spontaneous delivery, but extrauterine recurrence was detected during the postpartum period.…”

“…Several 'successful' cases of the uterus being preserved after diagnosis of ESS have been reported after a short follow-up period. [2][3][4][5][6][7][8] Here, we report a fatal case after long-term follow-up.…”