Fertility-sparing management of perivascular epithelioid cell tumors: A case report and literature review.

Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms. Approximately 25 % occur in the female reproductive tract. The treatment strategy suggested in the literature is largely limited to hysterectomy, with little consideration of fertility-sparing approaches in reproductive-aged patients. This report concerns the use of a fertility-sparing approach in the management of a nulligravid woman who presented with abnormal uterine bleeding. She was diagnosed with a cervical perivascular epithelioid cell tumor based on biopsy and immunohistochemical analysis. Imaging confirmed a localized cervical mass and an endometrial lesion. The patient underwent hysteroscopic removal of the endometrial mass. Loop electrosurgical excision was utilized for the cervical tumor. Pathology demonstrated a benign cervical perivascular epithelioid cell tumor and an endometrial polyp. The patient remained disease-free with negative pelvic magnetic resonance imaging at three, six, and twelve months. This case highlights a novel use of loop electrosurgical excision to preserve fertility in those with gynecologic tumors, although ongoing surveillance is essential to ensure long-term safety.