Spontaneous Conception and Uncomplicated Term Pregnancy after Fertility Preserving Surgery and Chemotherapy in a Young Woman with Embryonal Rhabdomyosarcoma of the Pelvic Wall

Ovarian failure after chemotherapy is a challenge for practitioners in infertility. We report a case of uncomplicated term pregnancy in a young woman undergoing surgery and chemotherapy for rhabdomyosarcoma of the pelvic wall. The woman has been followed up for 15 years. She underwent operative laparoscopy and a first course of chemotherapy together with GnRH agonist therapy when she was 22-year-old. An exploratory laparoscopy and a debulking laparotomy were performed after six months because of persistent intraperitoneal disease and were followed by multiple courses of chemotherapy together with GnRH agonist therapy. A laparotomy for adhesiolysis was performed after two years because of mechanical ileus. The woman conceived spontaneously and delivered at term when she was 30-year-old. The long term follow up demonstrated that menstrual pattern, conception and pregnancy were unaffected by surgery and chemotherapy. This case further suggests that attempts to preserve fertility at surgery are mandatory in young women with cancer.