The Oncologic Outcomes of Endometrial Cancer Metastasizing to the Adrenal Gland and Kidney: from Case to Analysis

Overview

Journal J Turk Ger Gynecol Assoc

Publisher Galenos Publishing House

Specialty Gynecology & Obstetrics

Date 2023 Sep 7

PMID 37675503

Authors

Okan Aytekin

Fatih Kilic

Burak Ersak

Mehmet Unsal

Serra Akar

Osman Turkmen

Gunsu Kimyon Comert

Kamil Hakan Muftuoglu

Taner Turan

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the oncologic outcomes of endometrial cancer metastasis to the adrenal gland and kidney, based on a case study and review of the literature.

Material And Methods: A systematic review of the medical literature was performed to identify articles about metastatic endometrial cancer to the adrenal gland and kidney from 1975 until 2021.

Results: A 55-year-old female patient was admitted to our center. On pelvic examination, a mass protruding out of the cervix was observed, which was shown to be endometrioid carcinoma on biopsy. Disease stage was IVB, based on radiological and pathological results and the International Federation of Gynecology and Obstetrics 2018 staging. Neo-adjuvant chemotherapy was given. After therapy, the patient underwent type 2 hysterectomy, bilateral salpingo-oophorectomy, total omentectomy and lymph node dissection. Left nephrectomy, left adrenalectomy and left hemicolectomy were also performed because the conglomerate tumor invaded the left kidney, left adrenal gland, and left colon mesentery. Pathological findings were consistent with metastasis of endometrioid carcinoma in the left adrenal gland, left kidney parenchyma and hilum.

Conclusion: Metastasis of endometrial cancer to the adrenal gland and kidney is extremely rare and metastasis to the kidney has been reported in only two previous cases. When there is an intraperitoneal spread of endometrial cancer, as well as ovarian cancer, cytoreductive surgery without leaving a residual tumor should be undertaken andshould include adrenalectomy and nephrectomy, if necessary.

References

Liu Y, Chi S, Zhou X, Zhao R, Xiao C, Wang H . Prognostic value of distant metastatic sites in stage IV endometrial cancer: A SEER database study of 2948 women. Int J Gynaecol Obstet. 2019; 149(1):16-23. DOI: 10.1002/ijgo.13084. View

Berretta R, Patrelli T, Faioli R, Mautone D, Gizzo S, Mezzogiorno A . Dedifferentiated endometrial cancer: an atypical case diagnosed from cerebellar and adrenal metastasis: case presentation and review of literature. Int J Clin Exp Pathol. 2013; 6(8):1652-7. PMC: 3726982. View

Park S, Bae G, Kim J, Kim H . Mesonephric-like Differentiation of Endometrial Endometrioid Carcinoma: Clinicopathological and Molecular Characteristics Distinct from Those of Uterine Mesonephric-like Adenocarcinoma. Diagnostics (Basel). 2021; 11(8). PMC: 8391898. DOI: 10.3390/diagnostics11081450. View

Fung-Kee-Fung M, Dodge J, Elit L, Lukka H, Chambers A, Oliver T . Follow-up after primary therapy for endometrial cancer: a systematic review. Gynecol Oncol. 2006; 101(3):520-9. DOI: 10.1016/j.ygyno.2006.02.011. View

Ryan M, Laios A, Pathak D, Weston M, Hutson R . An Unusual Presentation of Endometrial Cancer with Bilateral Adrenal Metastases at the Time of Presentation and an Updated Descriptive Literature Review. Case Rep Obstet Gynecol. 2020; 2019:3515869. PMC: 6942745. DOI: 10.1155/2019/3515869. View

Ayhan A, Taskiran C, Celik C, Yuce K, Kucukali T . The influence of cytoreductive surgery on survival and morbidity in stage IVB endometrial cancer. Int J Gynecol Cancer. 2002; 12(5):448-53. DOI: 10.1046/j.1525-1438.2002.t01-1-01133.x. View

Choyke P, White E, Zeman R, Jaffe M, Clark L . Renal metastases: clinicopathologic and radiologic correlation. Radiology. 1987; 162(2):359-63. DOI: 10.1148/radiology.162.2.3797648. View

Kobayashi E, Kawai A, Seki K, Tateishi U, Beppu Y . Bilateral adrenal gland metastasis from malignant fibrous histiocytoma: value of [F-18]FDG PET-CT for diagnosis of occult metastases. Ann Nucl Med. 2007; 20(10):695-8. DOI: 10.1007/BF02984682. View

Rekhi B . Mismatch repair protein deficient endometrioid adenocarcinomas, metastasizing to adrenal gland and lymph nodes: Unusual cases with diagnostic implications. Indian J Pathol Microbiol. 2015; 58(4):491-5. DOI: 10.4103/0377-4929.168859. View

10.

Lam K, Lo C . Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital. Clin Endocrinol (Oxf). 2002; 56(1):95-101. DOI: 10.1046/j.0300-0664.2001.01435.x. View

11.

Blecharz P, Urbanski K, Mucha-Malecka A, Malecki K, Reinfuss M, Jakubowicz J . Hematogenous metastases in patients with Stage I or II endometrial carcinoma. Strahlenther Onkol. 2011; 187(12):806-11. DOI: 10.1007/s00066-011-2250-6. View

12.

Patsavas K, Woessner J, Gielda B, Rotmensch J, Yordan E, Bitterman P . Optimal surgical debulking in uterine papillary serous carcinoma affects survival. Gynecol Oncol. 2011; 121(3):581-5. DOI: 10.1016/j.ygyno.2010.11.048. View

13.

Shiraishi T, Kisu I, Nakamura K, Iijima M, Matsuda K, Hirao N . Bilateral adrenal metastases of endometrial cancer with adrenal insufficiency. J Obstet Gynaecol Res. 2021; 47(11):4106-4109. DOI: 10.1111/jog.14998. View

14.

Nakano K, Schoene W . Endometrial carcinoma with a predominant clear-cell pattern with metastases to the adrenal, posterior mediastinum, and brain. Am J Obstet Gynecol. 1975; 122(4):529-30. DOI: 10.1016/s0002-9378(16)33550-5. View

15.

Izaki H, Takahashi M, Shiirevnyamba A, Taue R, Furumoto H, Bando Y . Long-term recurrence-free survivor after laparoscopic removal of solitary adrenal metastasis from endometrial adenocarcinoma. J Med Invest. 2010; 57(1-2):174-7. DOI: 10.2152/jmi.57.174. View

16.

Singh Lubana S, Singh N, Tuli S, Seligman B . Adrenal Metastasis from Uterine Papillary Serous Carcinoma. Am J Case Rep. 2016; 17:289-94. PMC: 4912349. DOI: 10.12659/ajcr.895143. View

17.

Cochrane E, Menzies A, Sweeney K, Burke W . Synchronous renal and para-aortic metastasis in a uterine serous carcinoma: A case review and clinical considerations. Gynecol Oncol Rep. 2019; 28:12-14. PMC: 6357498. DOI: 10.1016/j.gore.2019.01.009. View

18.

Baron M, Hamou L, Laberge S, Callonnec F, Tielmans A, Dessogne P . Metastatic spread of gynaecological neoplasms to the adrenal gland: case reports with a review of the literature. Eur J Gynaecol Oncol. 2008; 29(5):523-6. View

19.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

20.

Dalt G, Friziero A, Grego A, Serafini S, Fassina A, Blandamura S . Adrenal metastasis from endometrial cancer: A case report. World J Clin Cases. 2019; 7(14):1844-1849. PMC: 6692260. DOI: 10.12998/wjcc.v7.i14.1844. View