Clinical Case Report - Clinical analysis of three patients with multiple endometrial cancer lesions treated by hysteroscopic surgery combined with progesterone

Sep 24, 2026

Endometrial cancer is a major female reproductive tract malignancy, and preserving fertility is a key priority for eligible early-stage patients. This case report evaluates hysteroscopic surgery combined with progesterone in three patients presenting with menstrual disorders, irregular bleeding, and endometrial thickening. Hysteroscopy revealed diffuse and local endometrial bulges, and pathology showed complex hyperplasia with cancerous changes. Progesterone receptor expression was assessed by immunohistochemistry. All three patients achieved recovery within 2, 3, and 9 months, respectively.

LanguageEnglish

CategoryHealthcare

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Pages5

Reading Time13 min

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Introduction

Case presentation

Case 1

® Clinical Case Report Clinical analysis of three patients with multiple endometrial cancer lesions treated by hysteroscopic surgery combined with progesterone Case report Li Wang, MDa,* , Rimin Cong, MSa , Lili Zhang, MDb , Danni Zhang, MSa , Juntong Wu, BSa | Abstract
Rationale: Endometrial cancer (EC) is one of three common malignant tumors of the female reproductive tract, exceeded by cervical cancer. It has an incidence rate ranging from 3% to 10% with an increasing trend in recent years.
Patient concerns: To analyze the clinical effectiveness of hysteroscopic surgery combined with progesterone therapy inpatients with multiple lesions of endometrial cancer with fertility preservation.
Diagnoses: Multiple endometrial cancer lesions were present.
Interventions: Three patients presented with menstrual cycle disorders, irregular vaginal bleeding, and endometrial thickening. Diffuse and local bulges of the endometrium can be seen under hysteroscopy. The histopathological results showed varying degrees of complex endometrial hyperplasia with canceration. Progesterone receptor was detected in lesion tissues through immunohistochemical examination.
Outcomes: Case 1 fully recovered within 2 months, case 2 within 3 months, and case 3 within 9 months.
Lessons: Our data suggested the clinical efficacy of hysteroscopic surgery combined with progesterone therapy in patients with early multiple endometrial cancer, providing the precious experience of the clinical presentation.
Abbreviations: EC = endometrial cancer, ER = estrogen receptor, LNG-IUS = levonorgestrel-releasing intrauterine system, PR = progesterone receptor | | --- | | Keywords: early endometrial cancer, fertility preservation, hysteroscopy, multiple lesions, progesterone | 1. Introduction Endometrial cancer (EC) is 1 of 3 common malignant tumors of the female reproductive tract, exceeded by cervical cancer. It has an incidence rate ranging from 3% to 10% with an increasing trend in recent years.[1] About 65% of EC patients have no reproductive history. Surgery is the first choice for EC treatment, but it can lead to loss of fertility and affect the patient’s quality of life. This paper analyzes the data from 3 cases with early multi-focal EC which were treated by hysteroscopic surgery combined with progesterone in our hospital. Progesterone receptor was detected in lesion tissues, and patients had strong desires for fertility preservation. The clinical features, diagnostic parameters, and treatment measures are analyzed and summarized. The authors have no conflicts of interest to disclose. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. a Department of Obstetrics and Gynecology, The 964th Hospital, Changchun, Jilin Province, China, b Changchun University of Chinese Medicine, Changchun, Jilin Province, China. * Correspondence: Li Wang, Department of Obstetrics and Gynecology, The 964th Hospital, Changchun, Jilin Province 130062, China (e-mail: [baihe199166@qq.com](baihe199166@qq.com)). 2. Case presentation All patients were eligible for fertility-preserving therapy[2]: age ≤ 40 years old with a strong desire to preserve fertility; the lesion biopsy was characterized as well-differentiated endometrioid adenocarcinoma; immunohistochemical examination: estrogen receptor (ER) and progesterone receptor (PR) were positive; serum CA125 was normal; imaging evaluation showed the lesion was limited to the endometrium with myometrial invasion, cervical, and extrauterine lesions; IA clinical stage according to the stage guideline from International Federation of Obstetrics and Gynecology; normal liver and kidney function; no contraindications to drug treatment; all subjects and their legal guardians informed consent was signed by all patients, and they underwent regular follow-ups; all clinical trials were approved by the Ethics Committee of the

FAQs

What patients were included for fertility-preserving therapy in this report?

Patients met eligibility criteria including age ≤ 40 with strong fertility preservation desire, well-differentiated endometrioid adenocarcinoma on biopsy, ER/PR positivity, normal CA125, disease limited to the endometrium with specific invasion and no contraindications, with consent and ethics approval.

What diagnostic findings were reported for the multiple endometrial cancer lesions?

Under hysteroscopy, diffuse and local endometrial protrusions were observed, and histopathology showed complex endometrial hyperplasia with cancerous change. Immunohistochemistry detected progesterone receptor in lesion tissues, with ER and PR reported positive for included patients.

How was treatment effectiveness categorized and what outcomes were observed?

Effectiveness was grouped into complete reversal, partial reversal, no reversal, and recurrence based on post-treatment pathology and persistence or reappearance of cancer tissue. In the three cases, recovery occurred within 2 months (case 1), 3 months (case 2), and 9 months (case 3).

Sep 24, 2026

Uploaded by Emma Wilson