An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature Review
In endometrial cancer (EC), adrenal metastases are rare indicating advanced disease. We report an unusual presentation of EC with solitary adrenal metastases at the time of diagnosis and provide with an updated literature review. A 68-year-old woman was referred with postmenopausal bleeding of sever...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2019/3515869 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562145481457664 |
|---|---|
| author | Maisie Ryan Alexandros Laios Darshana Pathak Michael Weston Richard Hutson |
| author_facet | Maisie Ryan Alexandros Laios Darshana Pathak Michael Weston Richard Hutson |
| author_sort | Maisie Ryan |
| collection | DOAJ |
| description | In endometrial cancer (EC), adrenal metastases are rare indicating advanced disease. We report an unusual presentation of EC with solitary adrenal metastases at the time of diagnosis and provide with an updated literature review. A 68-year-old woman was referred with postmenopausal bleeding of several weeks’ duration. Imaging revealed a heterogenous uterine mass and bilateral malignant adnexal masses. Hysteroscopy, endometrial biopsies, and radiological guided biopsies of the adrenal masses confirmed poorly differentiated EC. A PET-CT reported both adrenal metastases being hypermetabolic and suspicious for malignancy. The patient received six neoadjuvant chemotherapy cycles with Carboplatin and Paclitaxel. A repeated CT scan confirmed size reduction for both primary tumour and metastases. The adrenal metastases were no longer PET-avid on repeat PET-CT scan. The patient received a course of hormonal treatment and as per adrenal MDT, she underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy followed by bilateral retroperitoneal laparoscopic adrenalectomy two months later. The patient remains asymptomatic on maintenance hydrocortisone 18 months post diagnosis. This is the first report of solitary synchronous adrenal metastases in a patient with EC. Central MDT review is key in providing individualised treatment recommendations of such rare entity. |
| format | Article |
| id | doaj-art-0680a7874e1b46f0aff3c25ed7de59c6 |
| institution | Kabale University |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-0680a7874e1b46f0aff3c25ed7de59c62025-02-03T01:23:20ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922019-01-01201910.1155/2019/35158693515869An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature ReviewMaisie Ryan0Alexandros Laios1Darshana Pathak2Michael Weston3Richard Hutson4Department of Gynaecologic Oncology, St. James’s University Hospital, Leeds, UKDepartment of Gynaecologic Oncology, St. James’s University Hospital, Leeds, UKDepartment of Cellular Pathology, St. James’s University Hospital, Leeds, UKDapartment of Radiology, St. James’s University Hospital, Leeds, UKDepartment of Gynaecologic Oncology, St. James’s University Hospital, Leeds, UKIn endometrial cancer (EC), adrenal metastases are rare indicating advanced disease. We report an unusual presentation of EC with solitary adrenal metastases at the time of diagnosis and provide with an updated literature review. A 68-year-old woman was referred with postmenopausal bleeding of several weeks’ duration. Imaging revealed a heterogenous uterine mass and bilateral malignant adnexal masses. Hysteroscopy, endometrial biopsies, and radiological guided biopsies of the adrenal masses confirmed poorly differentiated EC. A PET-CT reported both adrenal metastases being hypermetabolic and suspicious for malignancy. The patient received six neoadjuvant chemotherapy cycles with Carboplatin and Paclitaxel. A repeated CT scan confirmed size reduction for both primary tumour and metastases. The adrenal metastases were no longer PET-avid on repeat PET-CT scan. The patient received a course of hormonal treatment and as per adrenal MDT, she underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy followed by bilateral retroperitoneal laparoscopic adrenalectomy two months later. The patient remains asymptomatic on maintenance hydrocortisone 18 months post diagnosis. This is the first report of solitary synchronous adrenal metastases in a patient with EC. Central MDT review is key in providing individualised treatment recommendations of such rare entity.http://dx.doi.org/10.1155/2019/3515869 |
| spellingShingle | Maisie Ryan Alexandros Laios Darshana Pathak Michael Weston Richard Hutson An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature Review Case Reports in Obstetrics and Gynecology |
| title | An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature Review |
| title_full | An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature Review |
| title_fullStr | An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature Review |
| title_full_unstemmed | An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature Review |
| title_short | An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature Review |
| title_sort | unusual presentation of endometrial cancer with bilateral adrenal metastases at the time of presentation and an updated descriptive literature review |
| url | http://dx.doi.org/10.1155/2019/3515869 |
| work_keys_str_mv | AT maisieryan anunusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT alexandroslaios anunusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT darshanapathak anunusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT michaelweston anunusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT richardhutson anunusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT maisieryan unusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT alexandroslaios unusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT darshanapathak unusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT michaelweston unusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview AT richardhutson unusualpresentationofendometrialcancerwithbilateraladrenalmetastasesatthetimeofpresentationandanupdateddescriptiveliteraturereview |