{"paper_id":"ec660675-efab-4f8a-87d8-3477876293b7","body_text":"Abstract\nEndometrial carcinoma, the second most common gynecological cancer, is increasingly affecting younger women, particularly due to rising obesity rates. The need for precise molecular tools is paramount for better categorization and risk stratification, especially in fertility preservation, as current methods often fall short. Fertility preservation is considered for early-stage, nonmetastatic cases, but the role of molecular classifications in this area remains underexplored. We present the case of a 35-year-old woman with grade 2 p53abn endometrioid endometrial cancer who sought fertility preservation. Her initial treatment involved hysteroscopy-guided resection, hormonal therapy with megestrol acetate (MA), and close monitoring, but the disease recurred within six months. A literature review reveals that fertility preservation in p53abn endometrial carcinoma is poorly documented, with variable outcomes. Many cases indicate a poor response to progestin therapy and a heightened risk of recurrence, highlighting the need for personalized treatment approaches. Additionally, our case identifies “a novel PTEN somatic mutation (Tier 2C)” that has not been previously reported in endometrial cancer. This case underscores the essential role of molecular profiling in clinical decision-making and the need for ongoing research into molecular pathways. Integrating molecular classifiers into routine practice is crucial for improving risk stratification and treatment outcomes, especially in young women pursuing fertility preservation.\nSimilar content being viewed by others\nData Availability (data transparency)\nIf needed, data from this study are available upon reasonable request.\nCode Availability (software application or custom code)\nNot applicable.\nReferences\nSung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. 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Int J Mol Sci. 2020;21(17):6073.\nAcknowledgements\nThere is no acknowledgment in this study.\nFunding\nThis research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\nAuthor information\nAuthors and Affiliations\nContributions\nIbrahim Yalcin: Literature review, manuscript, submission, leading surgeon.\nHakan Kula and Alper Baysal: figures, manuscript, review.\nOmer Salih Akar: figures, review.\nMehmet Kefeli: conceptualization, manuscript.\nCorresponding author\nEthics declarations\nEthics Approval (include appropriate approvals or waivers)\nNot applicable.\nConsent to Participate (include appropriate statements)\nInformed consent is taken from the patient for participation and publication.\nConsent for Publication (include appropriate statements)\nInformed consent is taken from the patient for participation and publication.\nAttestation Statement\nData regarding any of the subjects in the study has not been previously published unless specified. Data will be made available to the journal editors for review or query upon request.\nConflicts of interest/Competing interests (include appropriate disclosures)\nThe authors declare that they have no competing interests. All authors declare that they have nothing to disclose.\nNot applicable.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nSupplementary Information\nBelow is the link to the electronic supplementary material.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nYalcin, I., Kula, H., Baysal, A. et al. Challenges in Fertility Preservation for p53abn Grade 2 Endometrioid Endometrial Cancer: A Case Report and Literature Review. Reprod. Sci. 32, 3539–3545 (2025). https://doi.org/10.1007/s43032-025-01990-9\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s43032-025-01990-9","source_license":"CC0","license_restricted":false}