Subcutaneous Metastasis of Cancer of the Endometrium
- 20 Downloads
Cancer of the endometrium is the third most common gynecological malignancy after cancer of the cervix and ovary in Kenya. Subcutaneous metastasis is unusual site for endometrial cancer. Few cases of cutaneous and subcutaneous metastases from cancer of endometrium have been reported in the literature. The main areas of cutaneous and subcutaneous metastases are abdominal, perineal surfaces, skin and toes. Disseminated lesions are associated with hematogenous spread, while some occur via lymphatic spread or contiguity.
We present a case of a 45-year-old female, Para 5 + 0, who presented to our gynecologic oncology clinic in July 2017. The patient was referred from a peripheral health facility for chemotherapy following radical hysterectomy in May 2017 for endometrial cancer. Histology results of the specimen taken during surgery showed endometrial Ca stage 2, grade 3. The patient developed a swelling on the right leg 6 months after completion of 6 cycles of carboplatin and paclitaxel. Biopsy from the leg showed features consistent with metastatic endometrioid adenocarcinoma. The patient was started on pegylated liposomal doxorubicin. Local radiation of the metastatic subcutaneous lesion was also done.
Cutaneous and subcutaneous metastases from cancer of the endometrium are rare. We recommend histologic evaluation of subcutaneous masses developing in patients with endometrial cancer or in those suspected to have endometrial cancer.
Compliance with Ethical Standards
Conflict of interest
The authors declare no conflict of interest.
The study was approved by the Moi University/Moi Teaching and Referral Hospital Institutional Research and Ethics Committee (IREC). The Approval Number is 0003167.
A written informed consent was obtained from the patient (prior to her demise) before the study was conducted.
- 1.American Cancer Society. Key statistics for endometrial cancer. Retrieved August 29, 2018, from https://www.cancer.org/cancer/endometrial-cancer/about/key-statistics.html.
- 2.de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Tubiana-Mathieu N, et al. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2018;19(3):295–309. https://doi.org/10.1016/S1470-2045(18)30079-2.CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI, Corton MM. Williams gynecology. 3rd ed., AccessMedicine, McGraw-Hill Medical. 2010; https://accessmedicine.mhmedical.com/book.aspx?bookid=1758. Accessed 2010.
- 4.Arenas M, Gascón M, Rovirosa À, Hernández V, Riu F, López I, Sabater S, et al. The effect of lymphadenectomy and radiotherapy on recurrence and survival in endometrial carcinoma. Experience in a population reference centre. Reports of practical oncology and radiotherapy. J Greatpoland Cancer Cent Pozn Pol Soc Radiat Oncol. 2015;20(1):50–6. https://doi.org/10.1016/j.rpor.2014.09.003.CrossRefGoogle Scholar
- 6.El M’rabet F, Hottinger A, George A, Tille J, El mesbahi O, Castiglione-Gertsch M, Bodmer A. Cutaneous metastasis of endometrial carcinoma: a case report and literature review. J Clin Gynecol Obstet. 2012;1(1):19–23.Google Scholar
- 7.Krathen RA, Orengo IF, Rosen T. Cutaneous metastasis: a meta-analysis of data. South Med J. 2003;96(2):164–7. https://doi.org/10.1097/01.SMJ.0000053676.73249.E5.CrossRefPubMedGoogle Scholar
- 15.Bassir BA, Boukhanni L, Kouchani M, Belabidia B, Asmouki H, Soummani A. Cutaneous metastasis from endometrial adenocarcinoma: case report and literature review. Webmed Cent Obstet Gynaecol. 2012;3(9):WMC003723.Google Scholar
- 18.Guckenberger M, Bachmann J, Wulf J, Mueller G, Krieger T, Baier K, Flentje M. Stereotactic body radiotherapy for local boost irradiation in unfavourable locally recurrent gynaecological cancer. Radiother Oncol. 2010;94(1):53–9. https://doi.org/10.1016/j.radonc.2009.12.004.CrossRefPubMedGoogle Scholar