Internal hemipelvectomy with left hip transposition of a recurrent non − specific molecular profile synchronous endometrial endometrioid and ovarian endometrioid cancer

• Internal hemipelvectomy is a rare and complex surgical procedure that could be employed to treat locally recurring synchronous gynecologic cancers of the pelvis. • Due to the complexity of the procedure, success relies on involving experts from different subspecialties, excellent nursing staff, and persistent postoperative rehabilitation. • The case provides further insight into the behavior and management of Non Specific Molecular Profile (NSMP) endometrial tumors, specifically synchronous endometrial and ovarian cancers. Synchronous endometrial and ovarian carcinoma (SEOC) usually affects young, premenopausal, and nulliparous individuals. Despite its relatively good clinical outcome, SEOCs may recur depending on the patient’s risk factors. While several reports describe primary cases of SEOC, the management of recurrent disease has not been defined. The authors report a case of a 38-year-old, nulligravid, who was diagnosed with a synchronous endometrial endometrioid and ovarian endometrioid carcinoma. She had local recurrences on the left pelvic region occurring at three-year intervals and was managed surgically. During the most recent tumor recurrence, the patient underwent an internal hemipelvectomy with left hip transposition for complete tumor resection. This complex procedure required a multidisciplinary team. The mass was sent for molecular analysis showing a non − specific molecular profile (NSMP). Postoperative adjuvant radiotherapy was discussed with the patient in a multidisciplinary setting. Given that clear surgical margins were achieved, the patient opted to forgo radiotherapy to avoid potential complications. The patient is on close surveillance and remains disease free four months from surgery. Currently, she has progressed to full weightbearing from an initial period of being wheelchair bound. This case highlights the behavior of NSMP endometrial tumors, specifically SEOCs. It also illustrates that localized recurrences of SEOCs could be treated aggressively with complete surgical resection. Given the complexity of these procedures, successful outcomes depend on a carefully coordinated operative plan developed by a multidisciplinary team of specialists.