Question 53 (part 2) · LEK · Endometrial cancer
A 26-year-old female has uterine curettage performed due to abnormal uterine bleeding and presents with the results indicating G1 endometrial cancer. The patient has never been pregnant but would like to in the future. What is the correct course of action in the case of the patient according to the current recommendations concerning the diagnosis and treatment of endometrial cancer and taking into account oncofertility principles?
- A. egg cells should be retrieved and banked. Then the uterus should be removed together with the lymph nodes. The patient could opt for surrogacy in the future.
- B. the endometrium should be resected.
- C. hormonal oral contraception should be started for 6 months and curettage should be repeated. If the results are normal, the patient should immediately try to conceive.
- D. before a decision on the treatment is made, MRI of the lesser pelvis or expert transvaginal ultrasound should be performed to rule out the invasion of the endometrium. Also, genetic syndromes predisposing the patient towards endometrial cancer (Lynch syndrome) should be excluded.
- E. in the case of this patient there is no oncofertility option. The uterus together with its appendages should be removed.
Hint
Before choosing fertility-sparing therapy, prove the cancer is confined to the endometrium and check for a hereditary cause.
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