足部疼痛：跟骨转移作为子宫内膜癌的首发症状
Pain in the foot: calcaneal metastasis as the presenting feature of endometrial cancer.
作者信息
Manolitsas Tom P, Fowler Jeffrey M, Gahbauer Reinhard A, Gupta Nilendu
机构信息
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The James Cancer Hospital and Solove Research Institute, The Ohio State University College of Medicine, Columbus, Ohio, USA.
出版信息
Obstet Gynecol. 2002 Nov;100(5 Pt 2):1067-9. doi: 10.1016/s0029-7844(02)02015-x.
BACKGROUND
Ninety percent of endometrial cancer cases present with abnormal bleeding. Bone metastasis as the presenting feature is extremely rare.
CASE
A 76-year-old woman presented with right heel pain. She had no vaginal bleeding or other symptoms suggestive of endometrial cancer. After failure of conservative therapy, imaging studies demonstrated a calcaneal metastasis. A biopsy showed adenocarcinoma. She received local radiation to her foot, with complete resolution of symptoms. Subsequent computed tomography scans showed multiple pulmonary nodules, pelvic and inguinal lymphadenopathy, and an enlarged uterus. Endometrial biopsy confirmed endometrial adenocarcinoma. She received palliative therapy and died 11 months after the diagnosis was made on the endometrial biopsy.
CONCLUSION
This case highlights the rare presentation of endometrial cancer with foot pain secondary to calcaneal metastasis. Aggressive treatment of bone metastases can provide effective palliation of symptoms.
背景
90%的子宫内膜癌病例表现为异常出血。以骨转移作为首发特征极为罕见。
病例
一名76岁女性因右足跟疼痛就诊。她没有阴道出血或其他提示子宫内膜癌的症状。保守治疗失败后，影像学检查显示为跟骨转移。活检显示为腺癌。她接受了足部局部放疗，症状完全缓解。随后的计算机断层扫描显示多个肺结节、盆腔和腹股沟淋巴结肿大以及子宫增大。子宫内膜活检确诊为子宫内膜腺癌。她接受了姑息治疗，在子宫内膜活检确诊后11个月死亡。
结论
本病例突出了子宫内膜癌以跟骨转移继发足部疼痛的罕见表现。积极治疗骨转移可有效缓解症状。
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