alexa Late Recurrence of Endometrial Carcinoma Mimicking Primary Colon Cancer-Case Report and Review of the Literature | OMICS International
ISSN: 2577-0535
Journal of Cancer Clinical Trials
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Late Recurrence of Endometrial Carcinoma Mimicking Primary Colon Cancer-Case Report and Review of the Literature

Ayelet Shai1,2*, Menachem Ben Shachar1 and LiatApel Sarid2,3

1Department of Oncology, Galilee Medical Center, Nahariya, Israel

2Bar Illan Faculty of Medicine, Zefad, Israel

3Pathology Institute, Galilee Medical Center, Nahariya, Israel

*Corresponding Author:
Ayelet Shai
Department of Oncology, Galilee Medical Center
Nahariya, Israel
Tel: 972-50-7887731
E-mail: [email protected]

Received date: December 07, 2016; Accepted date: January 06, 2017; Published date: January 14, 2017

Citation: Shai A, Shachar MB, Sarid L (2017) Late Recurrence of Endometrial Carcinoma Mimicking Primary Colon Cancer-Case Report and Review of the Literature. J Cancer Clin Trials 2:125.

Copyright: © 2017 Shai A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Cancer Clinical Trials


The highest risk of recurrence following therapy for early stage endometrial cancer is within 3 years, and the most frequent sites of recurrence are the vaginal vault and the pelvis.

We describe an unusual case of a patient with recurrent endometrial cancer to the wall of the sigmoid colon and adjacent lymph nodes, 15 years after radical therapy for early stage disease. The patient was treated by sigmoidectomy and adjuvant megesterol acetate. She is well more than 4 years thereafter.

Case Report

A 60 years old woman presented with post-menopausal bleeding and was diagnosed with endometrial carcinoma. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Her history was remarkable for diffuse large B cell lymphoma that was treated with the CHOP regimen (doxorubicin, cyclophosphamide, vincristine and prednisone) 3 years earlier, achieving a complete response. Pathologically the endometrial tumor was a well differentiated endometroid carcinoma, invading only the inner third of the myometrium. No extra- uterine disease was seen.

The patient continued surveillance and was well for 8 years, when she was diagnosed with recurrent lymphoma. She was treated with the CHOP regimen, dextrazoxan and Rituximab, again achieving complete response. 7 years later the patient underwent a colonoscopy due to increasing constipation. A polypoid mass obstructing the lumen was seen 20 cm from the anal verge. Biopsy of the lesion was consistent with adenocarcinoma. CT scan of the pelvis, abdomen and chest noted only thickening of the lumen of the sigmoid colon, and no other suspicious lesions.

The patient underwent sigmoidectomy and recovered without sequel. 2 ulcerated lesions were seen in the bowl mucosa measuring 6 and 5 centimeters in greatest diameter. Microscopically the tumor involved the mucosa, muscularis and subserosal fat, with lymphovascular invasion. 5 out of 49 lymph nodes examined were involved by the tumor. Tumor morphology was consistent with endometroid carcinoma (Figure 1), and this was supported by positive immunohistochemistry staining for Keratin-7, estrogen and progesterone receptors and lack of staining for CDX-2 and keratin 20.


Figure 1: Pathological assessment of the surgical specimen [A] H and E staining showing endomtroid type adenocarcinoma in the bowl wall. Immune-histochemical staining with CDX2 [B] and keratin 20 [C] which stain the colonic mucosa, and with keratin 7 [D] and estrogen receptor [E] which stain endometrial carcinoma.

The patient was started on megestrol acetate and has been taking it for 52 months. Currently she is well without evidence of recurrent disease.


We describe a case of endometrial carcinoma that recurred 15 years after surgery as an obstructing colonic lesion with lymph node metastases, mimicking primary colon carcinoma.

The most frequent sites of endometrial cancer recurrence are the vaginal vault and pelvis [1]. The highest risk pf recurrence in within the first 3 years [2], and very late recurrences are rarely seen.

Only 2 patients with isolated recurrences in the walls of hollow organs have been described in the English literature. Franchello et al. described a case of recurrent endometrial carcinoma to the wall of the rectum 28 years after primary surgery [3]. Tsurumaki et al. described a patient with recurrent endometrial carcinoma to the wall of the urinary tract 11 years after primary surgery [4]. Very late recurrences in the vaginal treated with radiotherapy have also rarely been described [5].

Our patient was initially treated for a low risk endometrial carcinoma. As expected, the other patients that were described with late recurrences also had low or intermediate primary disease - stage 1, grade 1 or 2 endometroid carcinomas. All patients, including our case, were treated with a curative intent for their recurrent disease and were well for a long period of time thereafter.

Tumor spread to the bowl wall probably occurs via hematogeneous spread. The sigmoid colon and the rectum are located in the pelvis; however, recurrences in these organs cannot be viewed as local recurrences. Following radical local treatment the risk of subsequent metastases is not known, and so is the benefit of adjuvant systemic treatment. The tumor in our patient has spread to the adjacent lymph nodes, suggesting a high risk for additional systemic metastases. However, the very long disease free survival suggests a slow-growing malignancy. Thus, the patient was started on adjuvant endocrine therapy and close surveillance.


Early stage endometrial cancer can rarely recur in the bowl wall, mimicking primary colon cancer. In patients with isolated recurrence, radical surgical therapy seems beneficial.


Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Recommended Conferences

Article Usage

  • Total views: 621
  • [From(publication date):
    February-2017 - Mar 20, 2018]
  • Breakdown by view type
  • HTML page views : 555
  • PDF downloads : 66

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals


[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version