Malicky E S, Kostic K J, Jacob J H, Allen W C
University of Missouri Hospital, Columbia, USA.
Eur J Gynaecol Oncol. 1997;18(6):492-4.
Endometrial carcinoma, the fourth most common cancer in women, is primarily a disease afflicting postmenopausal women and usually presents with vaginal bleeding or vaginal discharge. A slender, athletic 44-year-old woman was diagnosed with endometrial carcinoma after presenting with an isolated, solitary femoral bone metastasis. She had no symptoms except for progressive left knee pain. An open biopsy of the lesion in the proximal left femur revealed metastatic adenocarcinoma compatible with an endometrial primary. An endometrial biopsy subsequently revealed moderately differentiated endometrioid adenocarcinoma. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, and adjuvant chemotherapy. An aggressive metastatic workup revealed no other sites of metastatic disease. The femoral metastasis was treated with radiation. On chronic progestin therapy, the patient is clinically free of disease 2 years following diagnosis. Patients with endometrial carcinoma (with otherwise early stage disease) who present with an isolated skeletal lesion may represent an unusual group with perhaps a better prognosis. This patient received aggressive multi-disciplinary therapy and has had a two year progression-free interval.
子宫内膜癌是女性第四大常见癌症，主要困扰绝经后女性，通常表现为阴道出血或阴道分泌物异常。一名身材苗条、热爱运动的44岁女性在出现孤立的股骨骨转移后被诊断为子宫内膜癌。除了进行性左膝疼痛外，她没有其他症状。对左股骨近端病变进行的开放性活检显示为转移性腺癌，与子宫内膜原发癌相符。随后的子宫内膜活检显示为中度分化的子宫内膜样腺癌。患者接受了全腹子宫切除术和双侧输卵管卵巢切除术以及辅助化疗。积极的转移性检查未发现其他转移病灶。对股骨转移灶进行了放射治疗。在接受慢性孕激素治疗后，患者在诊断后2年临床上无疾病。出现孤立性骨骼病变的子宫内膜癌患者（其他方面为早期疾病）可能是一个特殊群体，预后可能较好。该患者接受了积极的多学科治疗，并且有两年的无进展期。
