Subcutaneous Metastasis of Cancer of the Endometrium

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.