CASE REPORT article
Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1696640
This article is part of the Research TopicCutting-Edge Strategies in Screening, Prevention, and Treatment in Gynaecologic OncologyView all 32 articles
Ovarian endometrioid tumor occurring in a patient with early-stage, low-risk endometrial carcinoma successfully treated by fertility-sparing management: a case report
Provisionally accepted
- 1Qingdao Women and Children's Hospital, Qingdao, China
- 2Qilu Hospital of Shandong University (Qingdao), Qingdao, China
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Rationale Endometrial carcinoma (EC) increasingly affects younger women, prompting interest in fertility-sparing treatments. Although hormonal therapy is a feasible option for carefully selected patients, there remains a substantial risk of recurrence or associated ovarian malignancy. Case presentation A 35-year-old premenopausal woman reported abnormal uterine bleeding characterized by increased menstrual flow over approximately one year. Diagnosis & Intervention She was diagnosed with stage IA, grade 1 EC managed initially with high-dose oral megestrol acetate followed by a levonorgestrel-releasing intrauterine system due to intolerance. Serial endometrial biopsies demonstrated histologic remission, after which the patient elected definitive surgery with hysterectomy and bilateral salpingectomy while preserving the ovaries. Uterine pathology confirmed absence of residual carcinoma. Follow-up & Outcomes During follow-up, a right adnexal cystic-solid mass was detected and categorized as Ovarian-Adnexal Reporting and Data System (O-RADS) ultrasound category 4, with MRI features raising suspicion. Comprehensive surgical staging confirmed a unilateral low-grade ovarian endometrioid carcinoma with squamous differentiation; staging and peritoneal cytology were negative. The patient recovered uneventfully and remains under surveillance without adjuvant therapy. Lessons This case highlights the rare occurrence of metachronous ovarian endometrioid carcinoma after successful fertility-sparing and hysterectomy, underscores the importance of shared decision-making regarding ovarian preservation, and supports risk-adapted surveillance strategies in this population.
Keywords: endometrial carcinoma, Fertility-sparing, Levonorgestrel-releasing intrauterine system, ovarian tumor, case report
Received: 01 Sep 2025; Accepted: 24 Sep 2025.
Copyright: © 2025 Tian, Song, Wang, Hao, Liu and Geng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chenchen Geng, gengchenchen@qiluhospital.com
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