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具有多骨转移和肌肉受累的无特定分子特征的子宫内膜样子宫内膜癌:病例报告及文献复习

Endometrioid endometrial carcinoma of no-specific-molecular-profile with multiple bone metastases and muscle involvement: Case report and review of the literature.

作者信息

Heidinger Martin, Koh Mei, Panzenboeck Mario, Lutz Thomas, Mertz Kirsten D, Huemer Hansjoerg, Vetter Marcus, Brigitte Frey Tirri

机构信息

Women's Clinic, Cantonal Hospital Baselland, Liestal, Switzerland.

Institute for Radiology and Nuclear Medicine, Cantonal Hospital Baselland, Liestal, Switzerland.

出版信息

Radiol Case Rep. 2022 May 6;17(7):2346-2352. doi: 10.1016/j.radcr.2022.03.096. eCollection 2022 Jul.

DOI:10.1016/j.radcr.2022.03.096
PMID:35570879
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9096466/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/8ce6fdbd269b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/70a6b3d911e2/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/6e2b9035632e/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/88a5705c14e6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/8ce6fdbd269b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/70a6b3d911e2/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/6e2b9035632e/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/88a5705c14e6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50fb/9096466/8ce6fdbd269b/gr4.jpg

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A clinicopathologic study of endometrial cancer metastatic to bone: Identification of microsatellite instability improves treatment strategies.子宫内膜癌骨转移的临床病理研究:微卫星不稳定性的鉴定可改善治疗策略。
Gynecol Oncol Rep. 2020 Feb 10;32:100549. doi: 10.1016/j.gore.2020.100549. eCollection 2020 May.
3
PD-L1 Expression in Endometrial Carcinoma Cells and Intratumoral Immune Cells: Differences Across Histologic and TCGA-based Molecular Subgroups.
PD-L1 在子宫内膜癌肿瘤细胞和肿瘤内免疫细胞中的表达:不同组织学和 TCGA 分子亚组之间的差异。
Am J Surg Pathol. 2020 Feb;44(2):174-181. doi: 10.1097/PAS.0000000000001395.
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Adjuvant Chemotherapy plus Radiation for Locally Advanced Endometrial Cancer.局部晚期子宫内膜癌的辅助化疗加放疗。
N Engl J Med. 2019 Jun 13;380(24):2317-2326. doi: 10.1056/NEJMoa1813181.
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Cancer of the corpus uteri.子宫体癌。
Int J Gynaecol Obstet. 2018 Oct;143 Suppl 2:37-50. doi: 10.1002/ijgo.12612.
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L1CAM further stratifies endometrial carcinoma patients with no specific molecular risk profile.L1CAM 进一步对没有特定分子风险特征的子宫内膜癌患者进行分层。
Br J Cancer. 2018 Aug;119(4):480-486. doi: 10.1038/s41416-018-0187-6. Epub 2018 Jul 27.
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