Multiple Colonic and Gastric Metastasis of Endometrial Adenocarcinoma - Case Report

Abstract

MULTIPLE COLONIC AND GASTRIC METASTASIS OF ENDOMETRIAL ADENOCARCINOMA -CASE REPORT (Abstract): INTRODUCTION:In the gynecological malignancies endometrial adenocarcinoma is the second most common, giving early hematogenous and lymphatic metastasis to the lungs, brain and bones. CASE REPORT: We present the case of a 71 year old patient who underwent surgery two years ago for endometrial adenocarcinoma and followed postoperatively multimodal oncological treatment. The patient was admitted in January 2013 in the First Surgery Clinic of the Emergency Clinical County Hospital Târgu Mureş, Romania, for chronic anemia, consumptive disease signs and subocclusive syndrome. The preoperative exams (upper and lower gastrointestinal endoscopy, thoracoabdominal computed tomography and ultrasound) found a tumor invading right, transverse and sigmoid colon as well as gastric antrum and spleen. A subtotal colectomy with ileo-rectal anastomosis was then performed associated with distal gastrectomy and splenectomy. The histopathological exams revealed gastric and colonic metastasis from the endometrial serous cancer operated two years ago. The postoperative evolution was uneventful. CONCLUSIONS: Endometrial cancer can metastasize to the colon and stomach even without the presence of endometriosis. Multivisceral resections and preoperative exams of the digestive tract are justified in terms of subjective complaints of an occlusive simptomatology.

Malignant Bowel Obstruction Due to Intraluminal Metastasis of Endometrial Adenocarcinoma Located in the Sigmoid Colon After Nine Years of Follow-Up

“…Although the most frequent location of metastasis from endometrial adenocarcinoma is at the lymph node level (48%), recurrence at the vagina (42%), lung (24%), and peritoneum (27%) is also common. The hematogenous or lymphatic route is responsible for them [ 2 , 5 ]. The location of metastases in the digestive tract is uncommon.…”

Rare Distal Metastasis of Endometrial Adenocarcinoma Impersonating as Primary Colon Cancer

“…Thus far, only 3 similar cases have been published in the literature. 2 , 3 , 5 Endometrial adenocarcinoma is the most common histologic subtype of endometrial cancer. The metastasis is mainly via lymphatic and hematogenous modes.…”

“…Molnar et al published a case of a 71-year-old female with a past history of endometrial adenocarcinoma status postsurgical resection who presented with anemia and bowel obstruction symptoms 2 years after the surgery. 5 By imaging and endoscopic evaluation, she was found to have a tumor invading the left colon as well as spleen and gastric antrum. She underwent left hemicolectomy, splenectomy, and distal gastrectomy.…”

Delayed metastatic endometrial carcinoma mimicking primary colon adenocarcinoma: A surprise histopathological finding

“…Jauregui et al 12 reported a case of disease recurrence of stage 3b endometrial cancer to the sigmoid colon 1 month after TAH-BSO, in an 89-year-old who presented with haematochezia. Finally, Molnar et al 13 presented a case of a 71-year-old who presented with sub-occlusive syndrome, weight loss and anemia, found to have recurrence of stage 3b serous endometrial cancer 2 years status post-surgical management and adjuvant chemoradiotherapy. Intraoperatively, she was found to have multiple metastatic lesions in the colon (ascending, transverse and descending) and the gastric antrum (with invasion of the lower pole of spleen).…”