Endometrial carcinoma with laparotomy wound recurrence: complete remission following surgery and chemotherapy consisting of paclitaxel and carboplatin

Güçer, Fatih; Puyan, Fulya Öz; Yılmaz, Özkan; Mulayim, Naciye; Balkanlı-Kaplan, Petek; Yüce, M. Ali

doi:10.1111/j.1525-1438.2005.00179.x

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…There is little evidence to support any practice to reduce PSM risk ( Curet, 2004 ). The LAP2 trial reported a low PSM incidence of 0.24%, which is acceptable compared to laparotomy ( Walker et al, 2012 , Gücer et al, 2005 ). Furthermore, the LAP2 trial concluded that the use of MIS was safe regardless of pathological subtype ( Walker et al, 2012 ).…”

Section: Discussionmentioning

confidence: 96%

Delayed and clinically isolated port site carcinosarcoma recurrence as an early indicator of disseminated disease

Dandapani

Seagle

Chacho

et al. 2015

Gynecologic Oncology Reports

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A 71-year-old woman with suspected endometrial cancer underwent robotic-assisted hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymph node dissection, and infracolic omentectomy revealing a stage II uterine carcinosarcoma with components of serous adenocarcinoma and undifferentiated spindle cell sarcoma. There was no evidence of distant metastasis at the time of surgery. However pelvic washings were positive for malignant cells. She received adjuvant chemotherapy and vaginal cuff brachytherapy. Forty months later she developed a subcutaneous mass at the location of previous port site which was confirmed to be recurrence of the uterine primary. She subsequently developed additional distant metastases to the abdominal wall, lungs, and bone. Port site metastasis (PSM) was the earliest indicator of disseminated metastatic disease in this patient. We review challenges in the management of patients with PSM and propose that PSM be considered as a sign of systemic disease even when presenting as an apparently isolated recurrence.

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Section: Discussionmentioning

confidence: 96%

Delayed and clinically isolated port site carcinosarcoma recurrence as an early indicator of disseminated disease

Dandapani

Seagle

Chacho

et al. 2015

Gynecologic Oncology Reports

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“…[13] We do not use a bag in our routine also because there are not strong evidence to recommend it. EC recurrences may also occur on incisional abdominal wounds/scars of laparotomic or mini invasive primary surgery, usually due to microscopic tumor seeding [26][27][28] : EC seeding on Bartholin's gland incision during preoperative hysteroscopy can also justify VMs. [9] Limited and conflicting data suggested that pneumoperitoneum may alter the peritoneal surfaces, favoring cancer cell adherence.…”

Section: Discussionmentioning

confidence: 99%

Solitary vulvar metastasis from early-stage endometrial cancer

Mandato¹,

Mastrofilippo

Palicelli³

et al. 2021

Medicine

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Rationale: Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. It is usually diagnosed at early-stage and presents a favorable prognosis. Conversely, advanced or recurrent disease shows poor outcome. Most recurrences occur within 2 years postoperatively, typically in pelvic and para-aortic lymph nodes, vagina, peritoneum, and lungs. Vulvar metastasis (VM) is indeed anecdotal probably because of the different regional lymphatic drainage from corpus uteri. Patient concerns: A 3 cm, reddish, bleeding lesion of the posterior commissura/right labia was found in a 74-year-old woman treated with radical hysterectomy, surgical staging, and adjuvant radiotherapy 1 year before for a grade 2 endometrioid type, International Federation of Gynecology and Obstetrics Stage IB. Vulvar biopsy confirmed the EC recurrence. Pelvic magnetic resonance imaging and positron emission tomography excluded other metastases so VM was radically resected. Diagnosis: Postoperative histopathology confirmed the diagnosis of grade 2 EC VM. Interventions: A radical excision of VM was performed. Outcomes: Patient died from a severe sepsis 27 months after first surgery. Lessons: Vulvar metastases can show different appearance, occurring as single or diffuse lesions on healthy or injured skin. The surgical approach seems not to influence the metastatic risk, but tumor seeding and vaginal injuries should be avoided. Whether isolated or associated with recurrence in other locations, vulvar metastases imply poor prognosis despite radical treatment. Therefore, any suspected vulvar lesion arisen during EC follow-up should be biopsied and monitored closely, despite that the vulva represents an unusual metastatic site.

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“…VMs may be due to direct tumor spread through vagina [10,14], which also represents the most frequently preoperatively-contaminated site because of tumor bleeding [24]. Moreover, EC-recurrences may occur on incisional abdominal wounds/scars of either laparotomy or mini-invasive surgery [21][22][23], usually due to microscopic tumor seeding during primary surgery [9]. EC-seeding on Bartholin's gland incision during preoperative hysteroscopy can also justify VMs [9].…”

Section: Discussionmentioning

confidence: 99%

Solitary Vulvar Metastasis from Early Stage Endometrial Cancer: Case Report and Literature Review

Mandato

Mastrofilippo

Palicelli

et al. 2020

Preprint

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Abstract BackgroundEndometrial cancer is the most common gynaecological malignancy in developed countries. It is usually diagnosed at early-stage and presents a favourable prognosis. Conversely, advanced or recurrent disease result in low response to therapy and poor outcome. Most recurrences occur within two years postoperatively, typically in pelvic and para-aortic lymph nodes, vagina, peritoneum, and lungs; unusual localizations include abdominal organs/wall, bones, brain, muscle. Vulvar metastasis are indeed anecdotal probably because the different regional lymphatic drainage from corpus uterus. Here, we report a case of vulvar metastasis from an early endometrial cancer comprehensive staged by laparoscopy and reviewed the literature discussing the different mechanisms of vulvar metastasis pathogenesis and the prognosis.MethodsWe reported a case of vulvar metastasis from an early stage endometrial cancer. We also collected and analysed articles written in English regarding vulvar metastasis form endometrial cancer published between January 1966 and May 2020. PubMed was used as a database for this search. Clinical and pathological characteristics, treatments and outcomes were assessed.In total, 19 cases of vulvar metastasis from endometrial cancer were found. Patients had a mean age of 66 years and were mostly asymptomatic. Labium major was the most common and usually unique site of metastasis. Vulvar metastasis were mostly nodular/mass-like lesions occurred in patients treated mostly for endometrial cancer at early stage. Median time to vulvar metastasis was ten months. Most of the metastasis were treated with surgery or radiotherapy. One third of patients presented a subsequent recurrence on average 11 months later. 61.1% of patients died of disease and 70 median overall survival was 16 months.Vulvar metastasis can show different appearance, occurring as single or diffuse lesions on healthyor injured skin, in patients treated for both early- and advanced-stage endometrial cancers. Surgicalapproach seems not to influence the risk of subsequent metastasis, but tumor seeding and vaginalinjuries should be avoided. Whether isolated or associated with recurrence in other locations, vulvarmetastasis are characterized by severe prognosis despite radical treatment. Therefore, any suspectedvulvar lesion arisen during endometrial cancer follow-up should be biopsied, despite the vulva represents an unusual metastatic site.ConclusionsVulvar metastasis can show different appearance. Surgical approach seems not to influence the risk of subsequent metastasis. Vulvar metastasis are characterized by severe prognosis despite radical treatment. Therefore, any suspected vulvar lesion arisen during follow-up should be biopsied.

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Endometrial carcinoma with laparotomy wound recurrence: complete remission following surgery and chemotherapy consisting of paclitaxel and carboplatin

Cited by 7 publications

References 9 publications

Delayed and clinically isolated port site carcinosarcoma recurrence as an early indicator of disseminated disease

Delayed and clinically isolated port site carcinosarcoma recurrence as an early indicator of disseminated disease

Solitary vulvar metastasis from early-stage endometrial cancer

Solitary Vulvar Metastasis from Early Stage Endometrial Cancer: Case Report and Literature Review

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