Duodenal recurrence of endometrial carcinoma: report of a rare metastatic site

Abstract

Endometrial carcinoma is one of the most common gynaecologic malignancies in the western society. Treatment of recurrent disease became more refined, with the study of molecular and hormonal receptors playing a central role. A 76-year-old caucasian woman presented to the emergency department with growing tiredness, and melaena. Past medical history included an endometrioid adenocarcinoma. The patient had undergone a hysterectomy with bilateral salpingo-oophorectomy with pelvic and paraaortic lymphadenectomy and was disease-free for 2 years. The endoscopy revealed an ulcerated lesion involving the second and third portions of the duodenum. Histopathologic examination confirmed a poorly differentiated adenocarcinoma of endometrial origin. She started palliative chemotherapy, remaining with adequate symptomatic control. Endometrial cancer recurrence typically occurs locally. The liver is the intra-abdominal organ most commonly involved. There are scarce reports of duodenal metastasis of malignancies originated in distant organs. The duodenum remains an uncommon metastization site and is rarely associated with endometrial cancer.

Metastasis of endometrial adenocarcinoma masquerading as a primary rectal cancer: A rare case report with literature review

“…Endometrioid adenocarcinoma was the most common histologic type of endometrial cancer, which accounting for 80% of all endometrial carcinomas. [3] Recurrence or metastasis of endometrial cancer occurring in intra-abdominal organs usually present in aggressive histopathologic types such as the serous and clear cell type. Endometrial cancer with higher stages have more propensity for direct invasion of surrounding organs and lymphatic or hematogenous metastasis.…”

“…[1,2] After the first treatment of endometrial carcinoma, about 64% of recurrences will present in the next 2 years. [3] Majority of recurrence or metastatic endometrial carcinoma occurs through local extension. The most commonly involved sites were liver, lungs, bones, brain, and peritoneal cavity.…”