Challenges in Fertility Preservation for p53abn Grade 2 Endometrioid Endometrial Cancer: A Case Report and Literature Review

Endometrial 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. Similar content being viewed by others Data Availability (data transparency) If needed, data from this study are available upon reasonable request. Code Availability (software application or custom code) Not applicable.

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There is no acknowledgment in this study. Funding This research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Author information Authors and Affiliations Contributions Ibrahim Yalcin: Literature review, manuscript, submission, leading surgeon. Hakan Kula and Alper Baysal: figures, manuscript, review. Omer Salih Akar: figures, review. Mehmet Kefeli: conceptualization, manuscript. Corresponding author Ethics declarations Ethics Approval (include appropriate approvals or waivers) Not applicable. Consent to Participate (include appropriate statements) Informed consent is taken from the patient for participation and publication. Consent for Publication (include appropriate statements) Informed consent is taken from the patient for participation and publication. Attestation Statement Data 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. Conflicts of interest/Competing interests (include appropriate disclosures) The authors declare that they have no competing interests. All authors declare that they have nothing to disclose. Not applicable. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions Springer 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. About this article Cite this article Yalcin, 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 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-025-01990-9