Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors

Fertility preservation (FP) is an important aspect of the treatment of young women diagnosed with serous borderline ovarian tumors (SBOT), with fertility sparing surgery recommended when possible. Concurrent treatment with aromatase inhibitor letrozole during ovarian stimulation (OS) could be used i...

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Main Authors: Valeria Lombardi Fäh, Federico Del Vento, S. Intidhar Labidi-Galy, Manuela Undurraga
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578924002108
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author Valeria Lombardi Fäh
Federico Del Vento
S. Intidhar Labidi-Galy
Manuela Undurraga
author_facet Valeria Lombardi Fäh
Federico Del Vento
S. Intidhar Labidi-Galy
Manuela Undurraga
author_sort Valeria Lombardi Fäh
collection DOAJ
description Fertility preservation (FP) is an important aspect of the treatment of young women diagnosed with serous borderline ovarian tumors (SBOT), with fertility sparing surgery recommended when possible. Concurrent treatment with aromatase inhibitor letrozole during ovarian stimulation (OS) could be used in women with hormone-sensitive breast cancer, but very little is known in gynecological tumors. Here, we report the cases of 2 young nulliparous women with early stage SBOT who underwent successful OS with letrozole. Patient 1 is 22-years old, FIGO IIB. She had a bilateral ovarian recurrence 5 months after the first surgery. She underwent OS with letrozole (four oocytes were collected and vitrified), followed by cytoreduction. The patient is in complete remission since 2 years. Patient 2 is 27-years old, FIGO IC3, treated by right adnexectomy. Ten months after surgery, she was in complete remission. OS with letrozole was performed and 4 oocytes were retrieved, resulting in 2 blastocysts that were cryopreserved. She had a successful pregnancy after in-vitro fertilization. She underwent a delivery via C-Section for obstetrical reasons that revealed a macroscopic suspicious lesion on the left ovary. Cystectomy was performed during C-section, confirming tumor recurrence. She underwent a second pregnancy uneventfully. During the second C-section, a partial cystectomy and multiples peritoneal biopsies were performed revealing tumor recurrence limited to the left ovary. She underwent left adnexectomy two months after C-Section without any recurrence. In conclusion, our case report described successful oocytes cryopreservation, without changes in the appearance of ovarian cysts, in nulliparous women with early-stage SBOT who underwent OS with simultaneous administration of letrozole.
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spelling doaj-art-11227efe63e342a187f8d0bcdbe4f8902025-08-20T02:37:42ZengElsevierGynecologic Oncology Reports2352-57892024-12-015610153110.1016/j.gore.2024.101531Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumorsValeria Lombardi Fäh0Federico Del Vento1S. Intidhar Labidi-Galy2Manuela Undurraga3Division of Gynecology, Department of Pediatrics and Gynecology, Hôpitaux Universitaires de Genève, Genève, SwitzerlandDivision of Gynecology, Department of Pediatrics and Gynecology, Hôpitaux Universitaires de Genève, Genève, SwitzerlandDepartment of Oncology, Hôpitaux Universitaires de Genève, Genève, Switzerland; Faculty of Medicine, Department of Medicine and Center of Translational Research in Onco-Hematology, University of Geneva, Swiss Cancer Center Leman, Genève, SwitzerlandDivision of Gynecology, Department of Pediatrics and Gynecology, Hôpitaux Universitaires de Genève, Genève, Switzerland; Corresponding author.Fertility preservation (FP) is an important aspect of the treatment of young women diagnosed with serous borderline ovarian tumors (SBOT), with fertility sparing surgery recommended when possible. Concurrent treatment with aromatase inhibitor letrozole during ovarian stimulation (OS) could be used in women with hormone-sensitive breast cancer, but very little is known in gynecological tumors. Here, we report the cases of 2 young nulliparous women with early stage SBOT who underwent successful OS with letrozole. Patient 1 is 22-years old, FIGO IIB. She had a bilateral ovarian recurrence 5 months after the first surgery. She underwent OS with letrozole (four oocytes were collected and vitrified), followed by cytoreduction. The patient is in complete remission since 2 years. Patient 2 is 27-years old, FIGO IC3, treated by right adnexectomy. Ten months after surgery, she was in complete remission. OS with letrozole was performed and 4 oocytes were retrieved, resulting in 2 blastocysts that were cryopreserved. She had a successful pregnancy after in-vitro fertilization. She underwent a delivery via C-Section for obstetrical reasons that revealed a macroscopic suspicious lesion on the left ovary. Cystectomy was performed during C-section, confirming tumor recurrence. She underwent a second pregnancy uneventfully. During the second C-section, a partial cystectomy and multiples peritoneal biopsies were performed revealing tumor recurrence limited to the left ovary. She underwent left adnexectomy two months after C-Section without any recurrence. In conclusion, our case report described successful oocytes cryopreservation, without changes in the appearance of ovarian cysts, in nulliparous women with early-stage SBOT who underwent OS with simultaneous administration of letrozole.http://www.sciencedirect.com/science/article/pii/S2352578924002108Ovarian stimulation with letrozole in serous borderline tumors
spellingShingle Valeria Lombardi Fäh
Federico Del Vento
S. Intidhar Labidi-Galy
Manuela Undurraga
Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors
Gynecologic Oncology Reports
Ovarian stimulation with letrozole in serous borderline tumors
title Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors
title_full Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors
title_fullStr Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors
title_full_unstemmed Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors
title_short Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors
title_sort ovarian stimulation with letrozole in nulliparous young women with relapsing early stage serous borderline ovarian tumors
topic Ovarian stimulation with letrozole in serous borderline tumors
url http://www.sciencedirect.com/science/article/pii/S2352578924002108
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AT sintidharlabidigaly ovarianstimulationwithletrozoleinnulliparousyoungwomenwithrelapsingearlystageserousborderlineovariantumors
AT manuelaundurraga ovarianstimulationwithletrozoleinnulliparousyoungwomenwithrelapsingearlystageserousborderlineovariantumors