Radiation treatment for refractory endometriosis: a 38-year-old female presenting with vaginal bleeding

In: Reports of Practical Oncology and Radiotherapy · 2021 · doi:10.5603/rpor.a2021.0057 · W3148095411
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A 39-year-old woman with refractory, inoperable endometriosis experienced complete resolution of bleeding and pelvic pain after receiving 30 Gy in 10 fractions of radiation.

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This paper reports a clinical case of a 38–39-year-old woman with medically refractory, inoperable endometriosis at the vaginal cuff causing uncontrolled vaginal bleeding and pelvic pain, after prior abdominal hysterectomy with bilateral salpingo-oophorectomy complicated by a history of vesicovaginal fistula. The authors treated the endometriotic target with external beam radiation totaling 30 Gy in 10 fractions using 10 MV and 18 MV photons, and at follow-up the patient had complete resolution of bleeding and pelvic pain. The report is limited as a single-patient case without a comparative design or systematic assessment of durability or adverse effects. This paper is centrally about endometriosis — it presents a case where radiation therapy was used for refractory vaginal cuff endometriosis with massive hemorrhage.

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Abstract

BACKGROUND: Endometriosis is typically managed with a medical or surgical approach, though some patients have medically refractory disease and are poor surgical candidates. CASE PRESENTATION: A 39-year-old woman presented to our facility with uncontrolled bleeding and pain from an endometriotic mass at the vaginal cuff. She had a history of abdominal hysterectomy with bilateral salpingo-oophorectomy, now with medically refractive and inoperable disease due to prior history of vesicovaginal fistula. We prescribed 30 Gy in 10 fractions with 10 MV and 18 MV photons to the target. At follow-up our patient reported a complete resolution of bleeding and pelvic pain. CONCLUSION: Radiation treatment can be an effective treatment for refractory endometriosis.
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Abstract

BACKGROUND: Endometriosis is typically managed with a medical or surgical approach, though some patients have medically refractory disease and are poor surgical candidates. CASE PRESENTATION: A 39-year-old woman presented to our facility with uncontrolled bleeding and pain from an endometriotic mass at the vaginal cuff. She had a history of abdominal hysterectomy with bilateral salpingo-oophorectomy, now with medically refractive and inoperable disease due to prior history of vesicovaginal fistula. We prescribed 30 Gy in 10 fractions with 10 MV and 18 MV photons to the target. At follow-up our patient reported a complete resolution of bleeding and pelvic pain.

Conclusion

Radiation treatment can be an effective treatment for refractory endometriosis.

Keywords

endometriosisradiation therapyradiotherapyvaginal bleeding

References

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