Metastatic recurrence after a pT1a grade 1 endometrioid endometrial adenocarcinoma

Developement metastasis in grade 1 endometrioid cancer is unusual. The author reports the case of a 71-year-old patient who presented with liver metastasis, peritoneal mets, and pulmonary lymphangitis. Two years before, she had been diagnosed with a pT1a Stage 1 endometrioid adenocarcinoma of the uterus. She underwent surgery: total hysterectomy and bilateral salpingo-oophorectomy. Histologically it was a Stage 1, grade 1, pT1a endometrioid-type endometrial cancer. There was no myometrial invasion, no lymphovascular space involvement, and peritoneal cytology was negative. No adjuvant treatment was required and the patient was followed up every six months. Two years after the surgery, the patient was admitted to hospital for anorexia, loss of weight, asthenia, and severe cough. Computed tomography scan showed disseminated metastasis in the liver, peritoneum, and pulmonary lymphangitis. Ca 125 levels were high at 432 kU/l. Biopsy cores of peritoneum were in favour of metastasis of the previous adenocarcinoma. The patient was referred to the oncology center to initiate chemotherapy with carboplatin + paclitaxel.

Endometrioid carcinoma; Gynaecological malingnancy; Peritoneal met; Endometrial cancer.

[1] Jemal A., Siegel R., Ward E., Murray T., Xu J, Smigal C., Thun M.J.: “Cancer statistics”. CA Cancer J. Clin., 2006, 56, 106.

[2] Parkin D.M., Bray F., Ferlay J., Pisani P.: “Global cancer statistics, 2002”. CA Cancer J. Clin., 2005, 55, 74.

[3] Siegel R., Ma J., Zou Z., Jemal A.: “Cancer statistics, 2014”. CA Cancer J. Clin., 2014, 64, 9.

[4] Powell J.L., Hill K.A., Shiro B.C., Diehl S.J., Gajewski W.H.: “Preoperative serum CA125 levels in treating endometrial cancer”. J. Reprod. Med., 2005, 50, 585.

[5] Jutzi L., Hoskins P., Lim P., Aquino-Parsons C., Tinker A., Kwon J.S.: “The importance of adjuvant chemotherapy and pelvic radiotherapy in high-risk early stage endometrial carcinoma”. Gynecol. Oncol., 2013, 131, 581.