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Diagnostic management of endometrial cancer in a single horn of a bicornuate uterus
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  1. Isabella Taglialatela1,
  2. Paulina Reyes1,2,
  3. Holli Nelson1,
  4. Hunter McSpedden1,
  5. Elizabeth Jacobi3,
  6. Thomas Bartl1,4 and
  7. Pedro T Ramirez1
    1. 1Department of Obstetrics and Gynecology, Neal Cancer Center, Houston Methodist Hospital, Houston, Texas, USA
    2. 2Department of Gynecologic Oncology, University of Chile, San Borja Arriarán Hospital, Santiago, Chile
    3. 3Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA
    4. 4Division of General Gynecology and Gynecologic Oncology, Department of Obstretics and Gynecology, Medical University Vienna, Vienna, Austria
    1. Correspondence to Dr Thomas Bartl, Division of General Gynecology and Gynecologic Oncology, Department of Obstretics and Gynecology, Medizinische Universitat Wien, Waerhinger Guertel 18-20, Vienna, Austria; thomas.bartl{at}meduniwien.ac.at

    https://doi.org/10.1136/ijgc-2024-005789

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      As more than 65 000 women are diagnosed with endometrial cancer annually in the US, and uterine malformations are relatively common in the general population (reported in up to 5%, with 25% of these being bicornuate uteri), the diagnostic and therapeutic implications of uterine malformations in patients with endometrial cancer are an under-reported clinical issue.1 2 To raise awareness of potential diagnostic and therapeutic pitfalls, we present a rare case of early stage endometrial cancer arising in a single horn of a bicornuate uterus (Figure 1). The patient was diagnosed by hysteroscopy and directed biopsies following postmenopausal bleeding and qualified for robotic hysterectomy with bilateral indocyanine green based sentinel lymph node resection, which was performed without complications. To date, evidence regarding the potential clinical implications of uterine malformations in relation to endometrial cancer is limited and largely confined to case reports.3 While anatomical variations may decrease diagnostic sensitivity and increase surgical complexity, there is no evidence suggesting impaired oncologic outcomes when uterine malformations are present. Therefore, if hysterectomy is deemed technically feasible without the risk of tumor spillage, there seems to be no contraindication for minimal invasive management in cases of early stage disease.

      Figure 1
      Figure 1

      Photograph taken during the initial hysteroscopic assessment of the uterine malformation, showing the bifurcation between the left and right horn following a single cervical os. The right horn harbored a benign endometrial polyp and the left horn was noted to have abundant polypoid tissue concerning for malignancy.

      Video 1 Hysteroscopy with directed biopsies of a bicornuate uterus

      Data availability statement

      There are no data in this work.

      Ethics statements

      Patient consent for publication

      Ethics approval

      This study involves human participants but no institutional review board approval was necessary because no identifiable patient characteristics are provided.

      References

      1. ↵
        1. Grimbizis GF,
        2. Camus M,
        3. Tarlatzis BC, et al
        . Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 2001;7:161–74. doi:10.1093/humupd/7.2.161
        OpenUrlCrossRefPubMedWeb of Science
      2. ↵
        1. Siegel RL,
        2. Miller KD,
        3. Wagle NS, et al
        . Cancer statistics, 2023. CA Cancer J Clin 2023;73:17–48. doi:10.3322/caac.21763
        OpenUrlCrossRefPubMed
      3. ↵
        1. Gao J,
        2. Zhang J,
        3. Tian W, et al
        . Endometrial cancer with congenital uterine anomalies: 3 case reports and a literature review. Cancer Biol Ther 2017;18:123–31. doi:10.1080/15384047.2017.1281495
        OpenUrlPubMed

      Footnotes

      • X @pedroramirezMD

      • Contributors IT, HN, and HM managed the underlying clinical case, collected video and photo material, and compiled all of the clincial data. IT prepared the first draft. PR edited the video and prepared it for publication, and contributed to the first draft. EJ provided images of pathologic specimens and helped prepare the figures. TB coordinated the project and revised the final draft. PTR conceived of the presented idea, supervised the project, revised the final draft, and is responsible for the overall content as guarantor. All authors discussed the results, commented on the video article, and approved the final version.

      • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

      • Competing interests None declared.

      • Provenance and peer review Not commissioned; externally peer reviewed.