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Endometrial cancer is the commonest gynecologic malignancy, of which adenocarcinoma is the most common histologic type. While most women who relapse present with local symptoms within 3 years of the initial diagnosis, metastatic disease usually involves the abdominal cavity and liver. Herein we present a rare case of a patient with a remote history...
Context in source publication
Context 1
... diffuse biliary dilation. She un- derwent an endoscopic retrograde cholangiopancreatography (ERCP) with failed biliary access due to inadequate positioning and poor fluoroscopy penetration to facilitate the procedure. Bil- iary drainge was successfully achieved via percutaneous transhe- patic cholangiogram and external biliary drain placement (Fig. ...
Citations
... Endometrial carcinoma is among the most common cancer in women all over the world, found in about 320,000 women all over the world yearly; about 76,000 women die because of the endometrial cancer. 8 Endometrial cancer is more common in developed countries where the lifetime risk of endometrial cancer is 1.6%, compared to 0.6% in developing countries. 9 Endometrial carcinoma was found in 12.9 out of 100,000 women in the developed world annually. ...
Objective:
To determine the association of polycystic ovarian syndrome (PCOS) with endometrial carcinoma in premenopausal females.
Study design:
Cohort study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Unit II, Sir Ganga Ram Hospital, Lahore, Pakistan, from July 2020 to January 2021.
Methodology:
Females aged between 20-45 years, presenting with irregular uterine bleeding were included. Females with PCOS were considered as the exposed group and females without PCOS were considered as the unexposed group. Dilation and curettage was performed, and histopathology reports were assessed.
Results:
There were total 70 patients (35 in each group). The mean age was 34.93±8.64 years in the exposed and 30.92±5.98 years in the unexposed group. Frequency percentage of endometrial carcinoma was 34.3% (n=24) in the exposed and 15.7% (n=11) in the unexposed group (OR=10.54).
Conclusion:
PCOS was found to be one of the risk factors for endometrial carcinoma.
Key words:
Polycystic ovarian syndrome (PCOS), Endometrial carcinoma, Premenopausal pre-menopause.
... Metastasis typically occurred in late-stage disease including locally (pelvic or para-aortic lymph nodes, vagina, or bladder) and distantly, especially lung, liver, bones, or peritoneum [2,4]. However atypical pattern of recurrence may be reported: pancreas or periampullary secondarisms resulting in obstructive jaundice or pancreatitis have been recently described [5]. ...
Endometrial endometrioid adenocarcinoma is the most common histology in gynecological malignancies. Most women present loco-regional relapsing or peritoneal and liver involvement within three years from diagnosis. However long-survivor patients may be affected by atypical disease evolutions. Here we describe an extremely rare case of retroauricular metastasis in a patient affected by endometrial endometrioid adenocarcinoma, who had a total abdominal hysterectomy and bilateral salpingo-oophorectomy six years earlier and subsequent salvage surgery three years later for loco-regional relapsed disease.
... Less than ten cases of pancreatic metastasis from squamous cell carcinoma of the cervix have been reported [243]. On the other hand, biliary obstruction most often results from external bile duct compression, particularly in the porta hepatis [244]. Cases of periampullary and lymph node metastases requiring percutaneous drainage have been reported [120,245]. ...
... Cases of periampullary and lymph node metastases requiring percutaneous drainage have been reported [120,245]. Endoscopic drainage has only been reported in one case to date [244]. ...
Malignant biliary obstruction generally results from primary malignancies of the pancreatic head, bile duct, gallbladder, liver, and ampulla of Vater. Metastatic lesions from other primaries to these organs or nearby lymph nodes are rarer causes of biliary obstruction. The most common primaries include renal cancer, lung cancer, gastric cancer, colorectal cancer, breast cancer, lymphoma, and melanoma. They may be difficult to differentiate from primary hepato-pancreato-biliary cancer based on imaging studies, or even on biopsy. There is also no consensus on the optimal method of treatment, including the feasibility and effectiveness of endoscopic intervention or surgery. A thorough review of the literature on pancreato-biliary metastases and malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer is presented. The diagnostic modality and clinical characteristics may differ significantly depending on the type of primary cancer. Different primaries also cause malignant biliary obstruction in different ways, including direct invasion, pancreatic or biliary metastasis, hilar lymph node metastasis, liver metastasis, and peritoneal carcinomatosis. Metastasectomy may hold promise for some types of pancreato-biliary metastases. This review aims to elucidate the current knowledge in this area, which has received sparse attention in the past. The aging population, advances in diagnostic imaging, and improved treatment options may lead to an increase in these rare occurrences going forward.
... In patients with non-hepato-biliary-pancreatic cancer, malignant biliary obstruction is frequently caused by metastasis from primary sites to abdominal lymph nodes, the hepatoduodenal ligament, or liver. Metastatic tumors that have been reported to cause extrahepatic biliary obstruction include cancer of the gastric tract [1][2][3], colorectum [4,5], lung [6][7][8], breast [9], kidney [10], ovary [11], and endometrium [12]. Most patients are found to be incurable at the time of diagnosis and have a poor prognosis. ...
Background
Malignant biliary obstruction secondary to metastatic cancer is associated with poor prognosis. To the best of our knowledge, no previous study has investigated long-term survival and associated prognostic factors after biliary endoscopic retrograde cholangiopancreatography (ERCP) drainage for obstruction jaundice secondary to various types of metastatic cancer.
Methods
This retrospective study included 60 patients who underwent biliary ERCP drainage for obstructive jaundice secondary to metastatic cancer at two hospitals during the period from November 2012 to December 2019. Multivariate analysis was conducted to identify independent prognostic factors.
Results
Biliary drainage was successfully achieved in 55 (91.7%) patients, 37 of whom received subsequent treatment. Overall median survival time was 133 days after stent placement. The overall survival (OS) rates after ERCP drainage were significantly better in the post-drainage treatment group than in the post-drainage untreated group (239 days vs. 45 days, p < 0.001). Good ECOG performance status before drainage, albumin level ≥ 35 g/L, successful drainage, absence of ascites, and post-drainage treatment were identified as factors of improved survival in univariate analysis. ECOG performance status and post-drainage treatment were independent predictors of OS in multivariate analysis.
Conclusions
We showed that stent placement with ERCP was a safe and effective treatment method for patients with malignant biliary obstruction caused by metastatic cancer and may be preferred over percutaneous transhepatic biliary drainage. Post-drainage treatment and a good ECOG performance status were predictors of better prognosis.
... One case was a 58-year-old woman with endometrial adenocarcinoma who developed a periampullary mass resulting in obstructive jaundice. 5 The second was a 78-year-old woman who developed paraduodenal and retroperitoneal masses causing extrinsic compression of distal bile duct resulting in obstructive jaundice. 6 Generally, young patients with endometrial cancer have good prognosis, especially in the absence of mismatch repair defects. ...
Clear cell carcinoma is an aggressive subtype of uterine carcinoma. Metastases can be local and/or distant but metastasis to the biliary tree resulting in obstructive jaundice is extremely rare. This is the first report of endometrial carcinoma of clear cell type with metastasis to the common hepatic duct, causing malignant biliary stricture and obstructive jaundice in a young woman, diagnosed on a biliary cytology brushing specimen.
