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EP532 A rare case of uterine body metastasis from cecal adenocarcinoma.

Abstract

Introduction/Background Bowel and uterine carcinomas are often related genetically, through hereditary syndromes or as metastasizing sides. Metastasis to the female genital tract from extragenital malignancies are rare, and the prognosis is extremely poor.

Methodology We herein report a case of a 62 years old woman with metastatic carcinoma to the uterine body from a colon adenocarcinoma, presenting with vaginal bleeding. 16 months before she had an urgent laparotomy due to obstructive ileus. She underwent right colectomy, right oophorectomy and lymphadenectomy and the histological results reported a colon-cecum adenocarcinoma (pT4aN0 grade2) up to the pericolic fat. The appendix, the right adnexa and the lymph nodes were negative. The imaging showed no metastasis to another organ. She received 9 cycles of chemotherapy with oxaliplatin and capecitabine (Xelox) and was followed up.

The diagnostic curettage that followed revealed a moderate adenocarcinoma of the uterus compatible with the colon adenocarcinoma (CK7 (+), CK20 (+), p16 (+), CDX2(+), ER (−), PR (−)).

Results Colonoscopy-biopsies were negative for malignancy and PET-CT reported a large uterus with focal disease and suspicious pelvic lymph nodes. The rest body scan was negative. She underwent wide total hysterectomy and left oophorectomy, excision of the mesorectum and parts of peritoneum, omentectomy and pelvic lymphadenectomy. The pathology examination reported the uterine adenocarcinoma infiltrating the serosa and myometrium. The mesorectum and 3/11 left lymph nodes were positive. The endometrium was atrophic and the left adnexa, the omentum and peritoneal parts excluded were negative for disease. The patient received 8 cycles of XELIRI-protocol (Capecitabine plus 3-weekly irinotecan) and is now -14 months after- free of relapse.

Conclusion According to our findings the tumor was developed of metastases in tissue continuity. To choose the best treatment, it is necessary to always diagnose whether a uterine bleeding is due to a primary uterine or a metastatic carcinoma.

Disclosure Nothing to disclose.

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