Endometrial adenocarcinoma in stein‐leventhal syndrome

Endometrium microscopically indistinguishable from well differentiated adenocarcinoma was obtained from four women ranging from 21 to 34 years of age with sclerocystic ovaries. Two were immediately treated with hysterectomy, which disclosed the lesions to be confined to the endometrium. One patient was treated with wedge resection of the ovaries. Re‐establishment of menses resulted, and she remains well 12 years later. The fourth patient had adenocarcinoma on a biopsy, and menses temporarily resumed after wedge resection and clomiphene therapy. However, metromenorrhagia again supervened, and hysterectomy was performed 2 years after the initial diagnosis. An adenocarcinoma was present which superfically invaded the myometrium. In no case was there deep invasion nor spread beyond the uterus, and the patients are well 1, 4, 5, and 12 years after the original diagnosis. A conservative approach is suggested for the patient with Stein‐Leventhal syndrome who has morphological changes of well‐differentiated endometrial adenocarcinoma. The lesion may be reversible when treated by curettage plus therapy directed toward re‐establishment of ovulation. Even if an irreversible, persistent invasive lesion is present that eventually requires ablative therapy, there is no evidence that delay is harmful to the survival of the patient.