Skip to main content
SpringerLink
Log in

Subcutaneous Metastasis of Cancer of the Endometrium

  • Case Report
  • Published:
Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Background

Cancer of the endometrium is the third most common gynecological malignancy after cancer of the cervix and ovary in Kenya. Subcutaneous metastasis is unusual site for endometrial cancer. Few cases of cutaneous and subcutaneous metastases from cancer of endometrium have been reported in the literature. The main areas of cutaneous and subcutaneous metastases are abdominal, perineal surfaces, skin and toes. Disseminated lesions are associated with hematogenous spread, while some occur via lymphatic spread or contiguity.

Case Presentation

We present a case of a 45-year-old female, Para 5 + 0, who presented to our gynecologic oncology clinic in July 2017. The patient was referred from a peripheral health facility for chemotherapy following radical hysterectomy in May 2017 for endometrial cancer. Histology results of the specimen taken during surgery showed endometrial Ca stage 2, grade 3. The patient developed a swelling on the right leg 6 months after completion of 6 cycles of carboplatin and paclitaxel. Biopsy from the leg showed features consistent with metastatic endometrioid adenocarcinoma. The patient was started on pegylated liposomal doxorubicin. Local radiation of the metastatic subcutaneous lesion was also done.

Conclusion

Cutaneous and subcutaneous metastases from cancer of the endometrium are rare. We recommend histologic evaluation of subcutaneous masses developing in patients with endometrial cancer or in those suspected to have endometrial cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. American Cancer Society. Key statistics for endometrial cancer. Retrieved August 29, 2018, from https://www.cancer.org/cancer/endometrial-cancer/about/key-statistics.html.

  2. de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Tubiana-Mathieu N, et al. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2018;19(3):295–309. https://doi.org/10.1016/S1470-2045(18)30079-2.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI, Corton MM. Williams gynecology. 3rd ed., AccessMedicine, McGraw-Hill Medical. 2010; https://accessmedicine.mhmedical.com/book.aspx?bookid=1758. Accessed 2010.

  4. Arenas M, Gascón M, Rovirosa À, Hernández V, Riu F, López I, Sabater S, et al. The effect of lymphadenectomy and radiotherapy on recurrence and survival in endometrial carcinoma. Experience in a population reference centre. Reports of practical oncology and radiotherapy. J Greatpoland Cancer Cent Pozn Pol Soc Radiat Oncol. 2015;20(1):50–6. https://doi.org/10.1016/j.rpor.2014.09.003.

    Article  Google Scholar 

  5. Finn WF. Time, site, and treatment of recurrences of endometrial carcinoma. Am J Obstet Gynecol. 1950;60(4):773–82. https://doi.org/10.1016/S0002-9378(16)39102-5.

    Article  CAS  PubMed  Google Scholar 

  6. El M’rabet F, Hottinger A, George A, Tille J, El mesbahi O, Castiglione-Gertsch M, Bodmer A. Cutaneous metastasis of endometrial carcinoma: a case report and literature review. J Clin Gynecol Obstet. 2012;1(1):19–23.

    Google Scholar 

  7. Krathen RA, Orengo IF, Rosen T. Cutaneous metastasis: a meta-analysis of data. South Med J. 2003;96(2):164–7. https://doi.org/10.1097/01.SMJ.0000053676.73249.E5.

    Article  PubMed  Google Scholar 

  8. Atallah D, el Kassis N, Lutfallah F, Safi J, Salameh C, Nadiri S, Bejjani L. Cutaneous metastasis in endometrial cancer: once in a blue moon—case report. World J Surg Oncol. 2014;12:86. https://doi.org/10.1186/1477-7819-12-86.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Baydar M, Dikilitas M, Sevinc A, Senel S, Senel F, Aydogdu I. Cutaneous metastasis of endometrial carcinoma with hemorrhagic nodules and papules. Eur J Gynaecol Oncol. 2005;26(4):464–5.

    CAS  PubMed  Google Scholar 

  10. Giardina VN, Morton BF, Potter GK, Mesa-Tejada R, Waterfield WC. Metastatic endometrial adenocarcinoma to the skin of a toe. Am J Dermatopathol. 1996;18(1):94–8.

    Article  CAS  Google Scholar 

  11. Bacalbasa N, Balescu I, Filipescu A. Subcutaneous metastasis from endometrial cancer; case report and literature review. J Clin Invest Surg. 2018;3(1):37–41.

    Article  Google Scholar 

  12. Elit L, Lukka H, Friedman E. Cutaneous metastasis of papillary serous uterine cancer. Gynecol Oncol. 2001;82(1):208–11. https://doi.org/10.1006/gyno.2001.6224.

    Article  CAS  PubMed  Google Scholar 

  13. Chang ES, Baker WD, Landen CN. Metastatic papillary serous uterine cancer presenting as a rash. Gynecol Oncol Rep. 2016;18:11–3. https://doi.org/10.1016/j.gore.2016.09.001.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kanyilmaz G, Aktan M, Koc M, Findik S. Cutaneous metastases of the synchronous primary endometrial and bilateral ovarian cancer: an infrequent presentation and literature review. Case Rep Oncol Med. 2016;2016:4568653. https://doi.org/10.1155/2016/4568653.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bassir BA, Boukhanni L, Kouchani M, Belabidia B, Asmouki H, Soummani A. Cutaneous metastasis from endometrial adenocarcinoma: case report and literature review. Webmed Cent Obstet Gynaecol. 2012;3(9):WMC003723.

    Google Scholar 

  16. Kubicek GJ, Xue J, Xu Q, Asbell SO, Hughes L, Kramer N, LaCouture T. Stereotactic body radiotherapy as an alternative to brachytherapy in gynecologic cancer. BioMed Res Int. 2013. https://doi.org/10.1155/2013/898953.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Deodato F, Macchia G, Grimaldi L, Ferrandina G, Lorusso D, Salutari V, Morganti AG. Stereotactic radiotherapy in recurrent gynecological cancer: a case series. Oncol Rep. 2009;22(2):415–9.

    PubMed  Google Scholar 

  18. Guckenberger M, Bachmann J, Wulf J, Mueller G, Krieger T, Baier K, Flentje M. Stereotactic body radiotherapy for local boost irradiation in unfavourable locally recurrent gynaecological cancer. Radiother Oncol. 2010;94(1):53–9. https://doi.org/10.1016/j.radonc.2009.12.004.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Reproductive Health, School of Medicine, Moi University, P.O. Box 3900-30100, Eldoret, Kenya

    Sahara Shurie, Loice Luhumyo, Elly Benjamin Odongo, Vincent Oyiengo & Orang’o Elkanah Omenge

  2. Faculty of Health Sciences, Egerton University, P.O. Box 536 – 20115, Nakuru, Kenya

    Emmanuel Wekesa Wamalwa

  3. Moi Teaching and Referral Hospital, P.O. Box 3 – 3100, Eldoret, Kenya

    Keitany Kibor Kibet

  4. AMPATH Oncology Institute, P.O. Box 4606 – 30100, Eldoret, Kenya

    Hellen Muliro

Authors
  1. Sahara Shurie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Loice Luhumyo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elly Benjamin Odongo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emmanuel Wekesa Wamalwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Vincent Oyiengo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Keitany Kibor Kibet
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Orang’o Elkanah Omenge
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hellen Muliro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sahara Shurie.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Ethical Approval

The study was approved by the Moi University/Moi Teaching and Referral Hospital Institutional Research and Ethics Committee (IREC). The Approval Number is 0003167.

Informed Consent

A written informed consent was obtained from the patient (prior to her demise) before the study was conducted.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shurie, S., Luhumyo, L., Odongo, E.B. et al. Subcutaneous Metastasis of Cancer of the Endometrium. Indian J Gynecol Oncolog 17, 55 (2019). https://doi.org/10.1007/s40944-019-0299-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40944-019-0299-9

Search

Navigation