Cutaneous and bony metastases after treatment of endometrial cancer – case report and review of the literature
Affiliation and adress for correspondence

1 Klinika Nowotworów Narządów Płciowych Kobiecych, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie.
Kierownik: prof. dr hab. n. med. Beata Śpiewankiewicz
2 Zakład Biologii Molekularnej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie.
Kierownik: prof. dr hab. n. med. Janusz A. Siedlecki
3 Szpital Kliniczny im. ks. Anny Mazowieckiej. Kierownik: prof. dr hab. n. med. Krzysztof Czajkowski
Correspondence to: Klinika Nowotworów Narządów Płciowych Kobiecych, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie,
ul. W.K. Roentgena 5, 02-781 Warszawa
Source of financing: Department own sources

CURR. GYNECOL. ONCOL. 2012, 10 (3), p. 244-252
ABSTRACT

In terms of incidence, endometrial cancer is the sixth most common malignancy in women. Endometrial cancer disseminates mainly by the lymphatics to regional lymph nodes. Hematogenous spread usually concerns lungs, liver and bones. Distant metastases are infrequent, usually develop in the lungs and occur in not more than 4.6% of the cases. Cutaneous metastases of endometrial cancer are extremely rare and are associated with a poor prognosis. We present a case of a 47-year-old patient, operated on for endometrial cancer. Histological study of surgical specimens revealed adenocarcinoma of uterine corpus at moderate grade of histological malignancy and at FIGO stage IIB. Four years after surgery, the patient developed metastases to bones and skin, including scalp. The case is a great rarity not only because of aggressive clinical course concomitant with a prognostically favorable histological diagnosis, but also in view of an highly unusual location of metastases. The paper outlines basic processes governing organ-specific location of metastases. Molecular mechanisms of development of metastases of endometrial cancer, particularly distant ones, is still relatively poorly understood. The paper presents evidence supporting the role of products of genes RUNX1/AML1 and ETV5/ERM in increasing the invasiveness of this tumor and development of metastases. Studies performed to date indicate that assessment of level of expression of these genes might help to identify patients at higher risk for a more aggressive clinical course, thereby contributing to the development of more effective treatment protocols.

Keywords: endometrial cancer, endometrial adenocarcinoma, cutaneous metastasis, bony metastasis, scalp metastasis, RUNX1/AML1, ETV5/ERM