Fertility preservation by testicular sperm extraction in a young patient with extraosseous Ewing’s sarcoma of the pelvis

Abstract

The survival of patients with childhood cancer has improved in recent decades and there is growing recognition of the importance of fertility preservation in these patients. Here, we describe the case of a 17-year-old patient with extraosseous Ewing’s sarcoma of the pelvis who underwent testicular sperm extraction (TESE) to preserve fertility before starting chemotherapy. The patient was admitted because of bladder-rectal disturbance and buttock pain and Ewing’s sarcoma was diagnosed. Sperm collection by masturbation was attempted but ejaculation was not possible because of nerve compression by the pelvic tumor. TESE was then performed and an adequate amount of sperm was collected and cryopreserved. Chemotherapy was started on the same day and there were no complications from the TESE. TESE is a safe and minimally invasive option for fertility preservation in postpubertal boys who have childhood cancer and cannot masturbate or ejaculate.