Case Presentation
A 68-year-old woman presented with a month history of formless stool. She had received hysterectomy for endometrial cancer 2 years ago. The level of cancer antigen 125 was elevated (46.77 U/mL; normal level, 0–35 U/mL). Other tumor markers were normal, including alpha fetoprotein, carcinoembryonic antigen and cancer antigen 199. Colonoscopy (Fig. 1A) showed a 50% circumferential extent tumor with superficial ulcer in the transverse colon, 60 cm from the anus. Abdominal contrast enhanced CT (Fig. 1B) demonstrated an oval mass involving the anterior wall of the transverse colon (red arrow), approximately 2.4 cm in diameter. A ring-like enhanced oval mass was also revealed in the right paracolic gutter (yellow arrow), approximately 3.2 cm in diameter. No other lesion was found, including the liver and lymph nodes. Photomicrograph of a colonoscopic biopsy of the mass in the transverse colon indicated metastatic endometrioid adenocarcinoma (Fig. 1C: the tumor containing cribriform structure with gland fusion), with the following immunohistochemistry results: Vimentin (+) (Fig. 1D), CDX-2 (-) (Fig. 1E), CK7 (+) (Fig. 1F), P16 (+) (Fig. 1G), CK20 (-), PR (-).
Common sites for endometrial cancer metastasis can involve most commonly the lymph nodes (48%), followed by the vagina, peritoneum, and lung.
1
,2
Metastatic endometrial cancer to the gastrointestinal track is quite rare.3
Given that metastatic colon cancer originating from endometrial cancer is mimicking colorectal cancer,1
clinicians must therefore keep in mind the possibility of metastatic disease especially when there is a prior history of malignancy.Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Declaration of Competing Interest
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this manuscript.
References
- Metastatic endometrial cancer to the sigmoid colon masquerading as primary colorectal cancer.Cureus. 2021; 13: e19646
- Endometrial adenocarcinoma metastatic to the colon masquerading as a primary colon cancer.J Gastroenterol Hepatol Res. 2012; 1: 40-43
- A rare case of endometrial cancer metastatic to the sigmoid colon and small bowel.Case Rep Gastrointest Med. 2017; 20179382486
Article info
Publication history
Published online: January 09, 2023
Accepted:
January 3,
2023
Received:
October 13,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
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