Endometrial metastasis of colorectal cancer with coincident endometrial adenocarcinoma

Abstract

SummaryMetastasis to the uterine corpus is uncommon and secondary colorectal tumours of the endometrium are rare. We describe a uterine tumour with components of both primary endometrial and metastatic colorectal carcinomata. In this case, a 72-year-old obese woman presented with a 2-week history of postmenopausal bleeding per vaginum and weight loss. She had an abdominoperineal resection 3 years previously for a Dukes stage B rectal carcinoma. A transvaginal ultrasonography showed a thickened endometrium. Histology immunophenotyping showed a CK7+, CK20+, CA125− and CEA+ colorectal metastasis (a profile consistent with her previous cancer) associated with a primary CK7+, CK20−, CA125+ and CEA− endometroid endometrial adenocarcinoma. We conclude this represents endometrial metastasis of colorectal carcinoma with coincident primary endometrial adenocarcinoma. We speculate as to whether the endometrial carcinoma arose de novo or was induced by the colorectal metastasis, or whether the primary endometrial tumour provided a fertile site for the colorectal metastasis.

Endometrium-limited Metastasis From Colon Carcinoma

“…The cases we selected are therefore believed to be embolic metastases reaching the endometrium through the hematogenous or lymphatic stream. Of the 6 cases presented in Table 1, only two showed no myometrial involvement [7,8], and one had less than 50% myometrial involvement in the absence of other systemic spread [9]. The time interval between the initial intestinal presentation and the uterine recurrence ranged from 8 months to 14 years with a median period of 52 months.…”

Endometrium-Limited Metastasis of Extragenital Malignancies: A Challenge in the Diagnosis of Endometrial Curettage Specimens

“…Metastatic tumors to the uterine body usually involve the myometrium; those exclusively involving the endometrium are rare. Endometrial involvement has been reported from breast carcinoma [13], colorectal carcinoma [3,7], gastric carcinoma [6], and malignant melanoma [2,4,31]. In cases of endometrial involvement, abnormal uterine bleeding appears to be the first presenting sign of metastasis [13,31].…”

“…Mazur et al [10] analyzed 56 cases of colorectal carcinoma with metastases to the female genital tract; only 2 (3.6%) cases in that cohort demonstrated endometrial involvement. Furthermore, only two case reports of endometrium-limited metastasis from colonic adenocarcinoma are available in literature [3,7]. In these case reports, there was no evidence of metastasis to other sites; concurrent primary endometrial carcinoma of the endometrioid type was identified in one case.…”

“…Embolic metastases to the uterine body are rare, particularly from extragenital malignancies. Numerous studies have investigated various aspects of metastatic tumors to the female reproductive organs [2][3][4][5][6][7][8][9][10][11]. However, to the best of our knowledge, only few case series of endometrial metastases from extragenital malignancies are available in literature [3,4,6,12,13].…”