Endometrioid endometrial adenocarcinoma stage IA associated with pregnancy: potential for treatment deferral (case report and literature review)

The coexistence of endometrial cancer and pregnancy is a rare clinical situation. However, global trends towards delayed childbearing and increasing cancer incidence among reproductive-age women raise the likelihood of encountering this pathology. We present a clinical case of a 35-year-old patient with morbid obesity (BMI 54.7 kg/m²) and secondary infertility, diagnosed with well-differentiated endometrioid adenocarcinoma (G1) confined to a 23 mm endometrial polyp, stage IA (p53wt, MMR-proficient, ER/PR+). Despite a multidisciplinary council recommendation for pregnancy termination, the patient chose to prolong the pregnancy. The gestation was complicated by threatened miscarriage but concluded with a planned cesarean section at 37—38 weeks, resulting in the birth of a healthy child. Hysterectomy was performed 3 months postpartum (pT1aN0M0, G2). An analysis of 33 published cases was conducted. It was demonstrated that in stage IA, G1 tumors, treatment deferral to allow pregnancy completion is not associated with disease progression and may be considered an oncologically safe option for carefully selected patients with informed consent and multidisciplinary support. Morbid obesity does not constitute an absolute contraindication for this approach.