Clinicopathologic features of bone metastases and outcomes in patients with primary endometrial cancer

Scalp and cranial vault fulminant relapse from an endometrial carcinoma

“…In our case, we observed scalp and cranial vault aff ectation as well as the 7th rib, which is very uncommon. Th e mean time of appearance is variable from 2 to 36 months, although we observed a very early relapse (just 4 months) and death aft er relapse (3 months), compared with the average of 32 months in the literature (Loizzi et al 2006;Kehoe et al 2010).…”

“…Kehoe et al (2010) studied 21 patients with bone metastasis from endometrial cancer and they observed that 76% of them presented with endometrioid carcinoma (86% of them grades 2 and 3), such as in our case. Th e incidence of bone metastasis seems to be 1 -15% (FIGO 2009;Crespo et al 2006;Albareda et al 2008;Kehoe et al 2010), although only case reports have been published. We have found just eight cases in the literature of scalp metastasis from endometrial cancer, and among them, just two also in the cranial vault.…”

“…In our case, we observed scalp and cranial vault aff ectation as well as the 7th rib, which is very uncommon. Th e mean time of appearance is variable from 2 to 36 months, although we observed a very early relapse (just 4 months) and death aft er relapse (3 months), compared with the average of 32 months in the literature (Loizzi et al 2006;Kehoe et al 2010).Th e best imaging technique for the follow-up seems to be the PETscan which shows the highest sensitivity. However, in some cases, such as the one reported here, the fast evolution of the disease makes an early diagnosis impossible.…”

“…Th e most common sites of metastatic endometrial cancer; the lung, liver, bones, central nervous system and skin (Albareda et al 2008;Kehoe et al 2010), are commonly related to high-grade endometrioid, serous papillary or clear cell histotypes. Kehoe et al (2010) studied 21 patients with bone metastasis from endometrial cancer and they observed that 76% of them presented with endometrioid carcinoma (86% of them grades 2 and 3), such as in our case.…”

“…Th e optimal treatment for bone metastases is still unclear, but the diff erent options include: radiation therapy (single metastasis), platinum-based chemotherapy (in multiple metastases), hormonal therapy and bisphosphonates (adjuvant to the other options) (Crespo et al 2006;Albareda et al 2008;Kehoe et al 2010). It is unclear if the addition of surgical treatment could improve the poor prognosis in such cases.…”