Fertility-Sparing Surgery for Stage I Endometrioid Ovarian Cancer

What happened, in summary

A 29-year-old woman being evaluated for infertility was found to have a left ovarian cyst. Laparoscopic cyst removal unexpectedly showed well-differentiated endometrioid ovarian carcinoma. The cyst had ruptured during the procedure, and she was referred for further treatment. BRCA1 and BRCA2 testing was negative.

Because she wanted future fertility, she chose fertility-sparing restaging surgery. The operation removed the left ovary and fallopian tube and included omentectomy, pelvic and para-aortic lymph-node sampling, peritoneal biopsies, and extensive removal of suspicious tissue from the left pelvic sidewall. Her uterus and right ovary were preserved. The staging samples and lymph nodes were benign, and the ovarian cancer was Stage I.

Her multidisciplinary team recommended adjuvant chemotherapy, and she completed 3 cycles of carboplatin and paclitaxel. She later conceived spontaneously twice and had two successful pregnancies. At 46 months after treatment, she remained without evidence of disease. Her story centers on treating an early ovarian cancer while preserving the possibility of pregnancy, with both long-term cancer control and future fertility reported during follow-up.