Heterotopic ovarian transplantation instead hormonal replacement therapy after radical hysterectomy for cervical cancer: case report and review of literature
Résumé
Only a few case reports have described heterotopic ovarian tissue transplantation (OTT) with the only objective
of restoring ovarian function.
Methods Case report and review of the literature for reporting cases of heterotopic OTT with the only aim of restoring ovar-
ian endocrine function. In a cancer survivor woman with a history of hysterectomy and bilateral oophorectomy for cervical
cancer and because she poorly tolerated hormone replacement therapy (HRT), we performed a heterotopic OTT in a pelvic
subcutaneous “pocket” after an OT cryostorage of 17 years.
Results A cyclic ovarian endocrine function started 3 months after OTT with an immediate patient self-described
improvement of her quality of life. A second OTT was performed 19 months after, due to hot flushes recurrence and
FSH increase. Despite a cyclic endocrine function, progesterone levels have always been low, resulting in a relative
hyperoestrogenism state.
Conclusion In the future, the indications of heterotopic OTT could be spread in alternative to HRT. However, our data sug-
gest that the heterotopic graft environment is less favorable to corpus luteum development, and further studies are needed
to assay the best site of heterotopic graft, the optimal number of ovarian cortex fragments to graft, and the potential risk of
relapse in case of malignant residual disease.
Domaines
CancerOrigine | Fichiers produits par l'(les) auteur(s) |
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