Abstract
It is important to remove endometrial polyps, which are well-known as a cause of implantation failure, from infertile female patients. Transcervical resection (TCR) is a treatment modality developed for endometrial polyps. We report a case involving a female with infertility due to an endometrial polyp which was shown to be an endometrial stromal sarcoma (low grade) after TCR.
The patient was a 30-year-old nulligravida. She had no significant medical history, and had been married for 13 months. Before seeking evaluation at Fukushima Medical University Hospital, she underwent a myomectomy under laparotomy at another hospital. According to the pathology report, the fibroid was a cellular myoma with no evidence of malignancy. However, an endometrial polypoid lesion was noted during hysterosalpingography after the follow-up examination. On transvaginal ultrasonography, the solitary polyp was 22 mm in diameter with a cystic component. Before surgery, she received GnRH analog treatment for 1 month. Based on the resected specimen, the polyp was highly suspected to be an endometrial stromal sarcoma, therefore she was informed that a hysterectomy with bilateral oophorectomy and pelvic lymphadenectomy was recommended for radical treatment. Two months later, the surgery was performed, and it was finally diagnosed that the uterine fibroma was composed of an endometrial stromal sarcoma (low grade). She was treated with oral medroxyprogesterone acetate without evidence of recurrence.
