子宮体癌への妊孕性温存療法後の帝王切開分娩後に発生したretained products of conceptionに対し子宮鏡下手術を施行した1例

抄録

　A 37-year old woman was diagnosed as early-stage endometrial cancer (G1 endometrioid carcinoma) during infertility treatment. The patient desired fertility preservation, and underwent fertility-preserving hormonal therapy. She became pregnant after successful cancer treatment and underwent cesarean section for breech presentation. During the surgery, it was observed that the placenta had adhered to the uterine wall, and it was removed manually. A postoperative examination revealed an intrauterine mass, which was diagnosed as retained products of conception (RPOC). Because active bleeding was not observed, conservative management was initiated. However, the lesion did not resolve. Therefore, we performed hysteroscopic surgery and endometrial curettage to evaluate the recurrence of endometrial cancer. A 2-cm white polypoid lesion was discovered in the uterus, and it was excised using a loop electrode. The resected margin was ischemic with little bleeding. The resected polypoid lesions were pathologically diagnosed as necrotic hyaline tissue, whereas that of the endometrial curettage lesion was endometrial hyperplasia. To determine the method and timing of treatment for RPOC, it is necessary to consider the presence or absence of active bleeding and individual characteristics of patients such as a history of endometrial cancer.