# Case Report: Spontaneous pregnancy after fertility-preserving treatment in a patient with low-grade endometrial stromal sarcoma and literature review

## TL;DR

A young woman with a rare uterine cancer had a successful pregnancy after fertility-preserving treatment, but later experienced cancer recurrence.

## Contribution

This case report highlights the potential for fertility-sparing treatment in young women with low-grade endometrial stromal sarcoma.

## Key findings

- A 29-year-old patient with stage IA LGESS conceived after fertility-preserving treatment.
- The patient experienced cancer recurrence eight months after delivery.
- Fertility-sparing treatment may be an option for carefully selected LGESS patients.

## Abstract

Low-grade endometrial stromal sarcoma (LGESS) is a rare malignant tumor of the uterus, characterized by slow growth. Early-stage LGESS is associated with favorable survival, but it has a high recurrence rate. The primary treatment for this disease is full-staging surgery. In this report, we present a case to explore the potential for fertility-preserving treatment in young women with LGESS.

A 29-year-old nulliparous patient diagnosed with stage IA LGESS underwent conservative treatment at the Obstetrics and Gynecology Hospital of Fudan University. After fertility-sparing surgery and three months of hormone treatment, no residual lesions were found. Subsequently, the patient conceived spontaneously and successfully delivered a healthy baby. However, she experienced recurrence eight months after delivery but declined hysterectomy and follow-up care.

Currently, there is still no standard management protocol for fertility preservation therapy in LGESS. Both previously reported cases and our case suggest that fertility-sparing treatment may be an option for carefully selected patients with LGESS. Further research and larger clinical studies are necessary to explore fertility-preserving treatments for young nulliparous patients with LGESS to establish guidelines or consensus.