Article Text
PDF
Abstract
Introduction/Background Endometrial cancer is the most common gynaecological tumour in developed countries. Almost 75–80% of patients present with FIGO (International federation of Gynaecology and Obstetrics) stage 1 disease and a local recurrence rate of 4–8%. An uncommon presentation of metastasis is pancreas.
Methodology We describe herein the rare case of a pancreas metastasis of grade 2 endometrial adenocarcinoma.
Results A 58-year-old woman underwent treatment of endometrial adenocarcinoma, staging surgery was performed in 2012. Hysterectomy contained a FIGO grade 2 endometrioid adenocarcinoma featuring depth of invasion more than half of myometrium. Lymh nodes andLymphovascular invasion was negative. The patient underwent adjuvant brachytherapy.
In 2015 resection of umblical mass with diameter of 4 × 4.5 cm from the rectus sheet was performed. Paclitaxel and carboplatin was administered for 6 cycles. In 2016, the patient was diagnosed with concomitant breast cancer and adjuvant radiotherapy was administered following surgery. After the excision of bilateral inguinal masses in 2017, she was administered 6 cycles of adriamycin and cisplatin. In 2018, during follow up examination CA 125 was detected 86 U/ml, abdominal imaging showed an invasive mass with a diameter of 2 cm in distal anterior pancreas. The cystic mass was removed by distal pancreatectomy. Intraoperatively left hemicolectomy was performed due to the mass detected in distal colon. Final pathology confirmed grade 2 endometrioid endometrial adenocarcinoma metastasis. Postoperatively the patient was discharged without any complication. After 6 cycles of paclitaxel and carboplatin follow up imaging showed no sign of recurrence.
Conclusion There are limited data in the literature for pancreas metastasis of low grade endometrial cancer. For the last two decades there are 4 cases reported. Although surgical resection appears to be beneficial according to literature, limited number of the cases seem to prevent a consensus on treatment strategies. We believe surgical resection should be offered to these patients.
Disclosure Nothing to disclose.
Abdominal bt image of the mass in the pancreas
5.7 × 5 cm implant in the distal inferior of the pancreas in abdominal MRG