Complete remission of an endometrial carcinoma with bilateral multiple pulmonary and extrapelvic metastases treated by surgery and chemotherapy consisting of paclitaxel and carboplatin

Abstract

Successful management of a patient with endometrioid type, grade 2 endometrial carcinoma with bilateral multiple pulmonary and extrapelvic abdominal metastases has been reported. A 61-year-old woman with the preoperative diagnosis of stage IVB endometrial carcinoma underwent surgery followed by six cycles of chemotherapy consisting of paclitaxel (175 mg/m2) and carboplatin (area under curve 5). After the sixth course, there were no abnormal findings on chest and abdominal computed tomography. She has no evidence of disease recurrence 24 months after the induction of chemotherapy. Tumor markers are within normal limits. Endometrial carcinoma with pulmonary metastases, especially those with bilateral multiple pulmonary metastases associated with additional extrapulmonary spread can be successfully treated by extensive surgery followed by chemotherapy consisting of paclitaxel and carboplatin.

Hematogenous metastases in patients with Stage I or II endometrial carcinoma

“…Brain involvement in EC is rare and is usually considered a late event. In the series reported in the literature, the incidence of brain metastases ranges from 0.3-0.9% [11,14,15,22,23,50], which is in accordance with the value of 0.6% (10/1610) in our group of patients.…”

“…In the literature, the survival rate for these patients is generally poor, with 1-year survival rates of 20-30% and 5-year survival rates of less than 10% [6,8,9,20,23,42,50].…”

“…Data from the literature and our own observations indicate that resection of pulmonary metastases combined with chemo-and/or hormonotherapy is a cornerstone treatment for patients with HM to the lung from EC, especially those with solitary HM [4,8,23,41]. Niwa et al [41] and Gücer et al [23] successfully treated patients with bilateral multiple pulmonary metastases with surgery followed by chemotherapy consisting of paclitaxel and carboplatin.…”

“…The data from the literature has shown that in patients with advanced or recurrent EC, ADR + CDDP, CBDCA + paclitaxel, and ADR + CDDP + paclitaxel are the most frequently used chemotherapy protocols worldwide [3,4,23,27,40,44,51].…”

Clinical outcome of metastatic uterine leiomyosarcoma and carcinosarcoma in a single institute

“…also reported that current chemotherapy drugs are minimally effective for uterine LMS 13 . These observations definitely differ from observations in endometrial cancer, in which combination chemotherapy appears to be the optimal treatment modality in pulmonary metastasis after primary surgery for hysterectomy 14–16 …”