Background. There have been several reports about successful fertility- preserving treatment of endometrial carcinoma with subsequent pregnancy. However, conservative hormonal treatment for early- stage endometrial cancer still entails some risk. Case. We present a 36- year- old nulliparous woman, initially diagnosed as clinical stage IA, grade 1 endometrial adenocarcinoma, receiving 6- month conservative treatment with remission achieved at 4 months from diagnosis. Recurrence at the endometrium was documented at the end of treatment. She underwent a definitive surgery including total hysterectomy, bilateral salpingo- oophorectomy, and pelvic lymph node dissection. The final pathology revealed well- differentiated endometrioid adenocarcinoma with inner one- third myometrial invasion and right ovarian metastasis. Conclusion. This case report signals a warning that negative preoperative imaging studies are not reassuring for a relapsing low- grade, early- stage endometrial carcinoma failing conservative treatment.
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