Curative polyendocrine therapy in a 21 year old patient with endometrial carcinoma. Case report and review of literature.

A 21-year-old patient diagnosed with atypical endometrial hyperplasia and suffering from hypermenorrhea and dysmenorrhea for several months was initially treated with MPA ( Medroxyprogesterone acetate). A control dilation and curettage (D&C) after 4 months revealed early-stage, well-differentiated endometrioid endometrial carcinoma. Despite national guidelines recommending a hysterectomy, the nulliparous patient with a desire to have children requested an organ-preserving procedure and underwent polyendocrine therapy with Letrozole, Everolimus, Metformin and Zoladex. 43 months after diagnosis, the patient gave birth to a healthy child. To date, there have been no signs of recurrence. This case suggests that triple endocrine therapy may be an option for selected patients with early endometrial cancer and a desire for fertility-sparing therapy.