Abstract：
Fertility-sparing treatments have become important for young women with atypical endometrial hyperplasia (AEH) or endometrial carcinoma (EC) who wish to preserve their reproductive potential. Evidence indicates a strong relationship between weight and EC and the effect of weight loss on reducing the risk of EC. We report the case of a young obese woman with a body mass index (BMI) of 46.6 kg/m2, diagnosed with grade 2 endometrial endometrioid adenocarcinoma, who underwent a combined fertility-sparing treatment with hysteroscopic resection followed by insertion of a levonorgestrel intrauterine system. After twelve months of failure to achieve a complete response, bariatric surgery was proposed to lose weight and improve the response to treatment. Histologic regression was achieved three months after surgery, with a weight loss of 30 kg and fifteen months after combined treatment of endometrial cancer. We reviewed the literature to summarize the evidence on the role of bariatric surgery and weight loss in modifying the oncologic and reproductive outcomes of women undergoing fertility-sparing treatment for atypical endometrial lesions.
摘要：
对于希望保留其生殖潜力的非典型子宫内膜增生（AEH）或子宫内膜癌（EC）的年轻女性，保留生育力的治疗已变得重要。证据表明，体重与EC之间存在很强的关系，以及体重减轻对降低EC风险的影响。我们报告了一个年轻的肥胖女性，其体重指数（BMI）为46.6kg/m2，诊断为2级子宫内膜样腺癌，接受宫腔镜切除联合保留生育力治疗，然后插入左炔诺孕酮宫内节育系统。在十二个月未能获得完整的回应之后，减重手术是为了减轻体重和改善对治疗的反应。手术后三个月实现组织学消退，联合治疗子宫内膜癌15个月后体重减轻30公斤。我们回顾了文献，以总结有关减肥手术和体重减轻在改善非典型子宫内膜病变的保留生育治疗妇女的肿瘤和生殖结局方面的作用的证据。
