Heidinger Martin, Koh Mei, Panzenboeck Mario, Lutz Thomas, Mertz Kirsten D, Huemer Hansjoerg, Vetter Marcus, Brigitte Frey Tirri
Women's Clinic, Cantonal Hospital Baselland, Liestal, Switzerland.
Institute for Radiology and Nuclear Medicine, Cantonal Hospital Baselland, Liestal, Switzerland.
Radiol Case Rep. 2022 May 6;17(7):2346-2352. doi: 10.1016/j.radcr.2022.03.096. eCollection 2022 Jul.
Bone metastasis and muscular involvement in endometrial carcinoma are rare, and information on molecular profiles of endometrial carcinoma with bone metastasis is scarce. We present a case of an 83-year old woman with a poorly differentiated endometrioid adenocarcinoma of no-specific-molecular-profile with para-aortic lymph node involvement, who underwent surgery, received adjuvant chemotherapy and vaginal brachytherapy but declined external beam radiotherapy. Fifteen months after the initial diagnosis she presented with pain in her right leg. Imaging showed an osteolytic lesion in the right femur with soft-tissue involvement. She underwent an open biopsy and protective osteosynthesis. Histologically, infiltrates of both bone and muscle were consistent with metastasis derived from endometrioid endometrial carcinoma. She received concomitant palliative chemotherapy and external beam radiotherapy to the right femur. Eleven months later, she presented with an acute hemiparesis caused by a right-sided subacute, superior frontal gyrus infarct, which also showed aggressive bone metastasis of the left sphenoid bone. She subsequently died 2 weeks later. This is a rare case of multiple bone metastases and muscle involvement in endometrial carcinoma. To our knowledge, this is the first reported such case in endometrial carcinoma showing no-specific-molecular-profile.
子宫内膜癌发生骨转移和肌肉受累的情况较为罕见,关于伴有骨转移的子宫内膜癌分子特征的信息也很匮乏。我们报告了一例83岁女性患者,患有未分化的非特异性分子特征的子宫内膜样腺癌,伴有主动脉旁淋巴结受累,她接受了手术、辅助化疗和阴道近距离放疗,但拒绝了外照射放疗。初次诊断15个月后,她出现右腿疼痛。影像学检查显示右股骨有溶骨性病变并伴有软组织受累。她接受了切开活检和保护性骨固定术。组织学检查显示,骨和肌肉中的浸润均与子宫内膜样子宫内膜癌转移相符。她接受了姑息性化疗并对右股骨进行了外照射放疗。11个月后,她因右侧额叶上回亚急性梗死导致急性偏瘫,同时左蝶骨也出现侵袭性骨转移。随后她在2周后死亡。这是一例罕见的子宫内膜癌发生多处骨转移和肌肉受累的病例。据我们所知,这是首例报道的无特异性分子特征的子宫内膜癌此类病例。