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

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 in patients 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.