Inguinal lymph node presenting as the delayed site of metastasis in early stage endometrial carcinoma: Case report

Akbar, S; Tunio, Mutahir A.; AlShakweer, Wafa; Alobaid, Abdulaziz; AlAsiri, Mushabbab

doi:10.1016/j.ijscr.2017.01.045

Cited by 6 publications

(5 citation statements)

References 8 publications

(9 reference statements)

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“…Metastatic spread to the lymph nodes occurs in only 4% of cases with grade 1 superficial endometrial cancer [7]. Inguinal lymph node involvement is rare and only a few cases have been reported [4, 8–10]. To our knowledge, this is the first case of metastatic high-grade serous carcinoma of the groin, which was first diagnosed as a relapse of EC.…”

Section: Discussionmentioning

confidence: 99%

Endometrioid endometrial cancer “recurring” as high-grade serous adenocarcinoma in the inguinal lymph nodes in a patient with germline MLH1 mutated Lynch syndrome: consequence or coincidence?

Jiang

Gao

Tao

et al. 2019

Hered Cancer Clin Pract

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Background Inguinal metastasis of endometrial cancer (EC) is rare. The aims of the study were to identify whether the inguinal metastatic tumor was originated from EC and to present the management of the disease. Methods The clinical data of a case of endometrioid EC “recurring” as serous adenocarcinoma in the inguinal lymph nodes were collected and analyzed. Paired samples of primary and metastatic tumors were used for exome sequencing to determine whether the tumors are same origination and to identify potential gene mutations associated with the relapse. Results The patient presented with right inguinal lymphadenopathy and histopathology revealed metastatic serous adenocarcinoma. A germline MLH1 mutation was identified. A combination of bioinformatical methods and cancer-related gene exome sequencing assay identified that only 17 (0.1%) somatic gene mutations were shared by the primary EC and the metastatic inguinal tumor, suggesting that the metastasis did not originate from the primary EC. Postoperative radiation therapy followed by a combination of chemotherapy were performed. Thirty-four months after that, the patient was doing well without any evidence of recurrence. Conclusions This is the first case of metastatic inguinal serous adenocarcinoma in a woman with Lynch syndrome shortly after surgical treatment of stage I endometrioid EC. Electronic supplementary material The online version of this article (10.1186/s13053-019-0112-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Endometrioid endometrial cancer “recurring” as high-grade serous adenocarcinoma in the inguinal lymph nodes in a patient with germline MLH1 mutated Lynch syndrome: consequence or coincidence?

Jiang

Gao

Tao

et al. 2019

Hered Cancer Clin Pract

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“…However, only one of the cases with inguinal recurrence had a history of unopposed estrogen based on our literature review. The other hypothesis for isolated PNR is that there is a possibility of missing a metastasis due to the poor value of preoperative imaging in the detection of inguinal micrometastasis, especially for advanced disease ( 10 ). There is also a lower rate of detection of micrometastasis on initial evaluation of the retroperitoneal lymph nodes for early stages.…”

Section: Discussionmentioning

confidence: 99%

“…Due to its infrequency, it is important to detect patients who are at high risk for peripheral lymphatic failure. Treatment options range from local surgical excision to pelvic exenteration, chemotherapy, radiotherapy and palliative therapy ( 9 , 10 , 11 ). Furthermore, the limited information on PNR in EC is based solely on cases from the literature.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of peripheral nodal recurrence in patients with endometrial cancer

Kılıç¹,

Cömert²,

Akar³

et al. 2022

J Turkish German Gynecol Assoc

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Objective: To evaluate the clinico-pathological patient features, prognostic factors, treatment options and outcomes of peripheral nodal recurrence (PNR) of endometrial cancer (EC). Material and Methods: The data of nine patients with PNR of EC from two institutions were reviewed. The electronic literature was reviewed from 1972 to May 2018 to identify articles about PNR in EC. Finally, 42 cases were evaluated. Results: Nineteen (45.2%) patients were initially diagnosed with either stage I or II disease, whereas 20 (47.7%) patients had stage III or IV disease while the stages were not reported in three (7.1%). PNR developed as the first recurrence in 40 (95.2%) patients and as the second recurrence in 2 (4.8%) patients. Isolated PNR appeared in 35 (83.3%). Seven (16.7%) had PNR coexisting with multiple other sites of tumoral involvement. In the entire cohort, the 5-year and 10-year post-recurrence survival (PRS) were both 78%. Only the presence of distant hematogenous metastasis concurrent with PNR was significantly related to poor PRS (p=0.005). Among patients with isolated PNR, those who had surgery had 30% greater 5-year PRS than those treated without surgery, but this difference was not significant (80% vs 50%; p>0.05). Conclusion: A concurrent distant hematogenous metastasis was the only factor related to poor survival. A wide range of therapies exists for PNR but none of the therapies appear to be more advantageous than another. However, surgery as a component of treatment can render a survival advantage for patients who have isolated PNR.

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“…12), malignant melanoma, and squamous cell carcinoma of skin over lower extremities or trunk. 17 Metastasis to lymph nodes has a significant impact on staging each pelvic tumor, treatment, and the prognosis.…”

Section: Lymph Nodes In Inguinal Regionmentioning

confidence: 99%

A Radiological Review of the Unusual Contents of Inguinal Region

GANESAN

Ramachandran

Raji

et al. 2023

Indian J Radiol Imaging

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Background The inguinal region is an area of complex anatomy that could contain diverse uncommon contents in routine clinical practice. Although inguinal hernia repair is one of the commonest surgeries done routinely, thorough preoperative imaging has a significant impact on the outcome of the surgery, by revealing the presence of unusual contents in the inguinal region. Aim The aim of this article is to review the differential diagnosis of the uncommon inguinal pathologies, which can simulate an inguinal hernia, to determine, and to simplify the treatment approach. Conclusions A profound understanding of the imaging characteristics of uncommon inguinal pathologies is crucial for both the radiologists (to prevent misdiagnosis) and the treating physicians (to avoid surgical complications) and ensure optimal management.

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Inguinal lymph node presenting as the delayed site of metastasis in early stage endometrial carcinoma: Case report

Abstract: HighlightsInguinal lymph nodes metastasis are rare in endometrial carcinoma.Proper preoperative assessment is important.CT-PET imaging is important tool in obese patients.Treatment is surgery and adjuvant chemo-radiotherapy.

Cited by 6 publications

References 8 publications

Endometrioid endometrial cancer “recurring” as high-grade serous adenocarcinoma in the inguinal lymph nodes in a patient with germline MLH1 mutated Lynch syndrome: consequence or coincidence?

Endometrioid endometrial cancer “recurring” as high-grade serous adenocarcinoma in the inguinal lymph nodes in a patient with germline MLH1 mutated Lynch syndrome: consequence or coincidence?

Evaluation of peripheral nodal recurrence in patients with endometrial cancer

A Radiological Review of the Unusual Contents of Inguinal Region

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