Aytekin Okan, Kılıç Fatih, Ersak Burak, Ünsal Mehmet, Akar Serra, Türkmen Osman, Kimyon Cömert Günsu, Müftüoğlu Kamil Hakan, Turan Taner
Department of Gynecologic Oncology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey.
Department of Pathology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey.
J Turk Ger Gynecol Assoc. 2023 Sep 7;24(3):172-176. doi: 10.4274/jtgga.galenos.2023.2022-11-3.
To evaluate the oncologic outcomes of endometrial cancer metastasis to the adrenal gland and kidney, based on a case study and review of the literature.
A systematic review of the medical literature was performed to identify articles about metastatic endometrial cancer to the adrenal gland and kidney from 1975 until 2021.
A 55-year-old female patient was admitted to our center. On pelvic examination, a mass protruding out of the cervix was observed, which was shown to be endometrioid carcinoma on biopsy. Disease stage was IVB, based on radiological and pathological results and the International Federation of Gynecology and Obstetrics 2018 staging. Neo-adjuvant chemotherapy was given. After therapy, the patient underwent type 2 hysterectomy, bilateral salpingo-oophorectomy, total omentectomy and lymph node dissection. Left nephrectomy, left adrenalectomy and left hemicolectomy were also performed because the conglomerate tumor invaded the left kidney, left adrenal gland, and left colon mesentery. Pathological findings were consistent with metastasis of endometrioid carcinoma in the left adrenal gland, left kidney parenchyma and hilum.
Metastasis of endometrial cancer to the adrenal gland and kidney is extremely rare and metastasis to the kidney has been reported in only two previous cases. When there is an intraperitoneal spread of endometrial cancer, as well as ovarian cancer, cytoreductive surgery without leaving a residual tumor should be undertaken andshould include adrenalectomy and nephrectomy, if necessary.
基于病例研究和文献综述，评估子宫内膜癌转移至肾上腺和肾脏的肿瘤学结局。
对医学文献进行系统综述，以确定1975年至2021年间有关子宫内膜癌转移至肾上腺和肾脏的文章。
一名55岁女性患者入住我院。盆腔检查时，发现宫颈有一肿物突出，活检显示为子宫内膜样癌。根据影像学和病理结果以及国际妇产科联盟2018年分期，疾病分期为IVB期。给予新辅助化疗。治疗后，患者接受了II型子宫切除术、双侧输卵管卵巢切除术、全大网膜切除术和淋巴结清扫术。由于肿瘤团块侵犯了左肾、左肾上腺和左结肠系膜，还进行了左肾切除术、左肾上腺切除术和左半结肠切除术。病理结果与子宫内膜样癌转移至左肾上腺、左肾实质和肾门相符。
子宫内膜癌转移至肾上腺和肾脏极为罕见，此前仅有两例报道过转移至肾脏的情况。当子宫内膜癌以及卵巢癌发生腹腔内播散时，应进行不留残余肿瘤的细胞减灭术，必要时应包括肾上腺切除术和肾切除术。
