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Case Report
Common cancer, puzzling presentation: A report of endometrial cancer presenting as an obstructive duodenal mass
1 Cleveland Clinic Women’s Health Institute, Department of OBGYN, Cleveland, Ohio, USA
2 Cleveland Clinic Women’s Health Institute, Division of Gynecologic Oncology, Cleveland, Ohio, USA
3 Cleveland Clinic, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland, Ohio, USA
Address correspondence to:
Ji Son
MD, MS, 9500 Euclid Ave, Desk A81, Cleveland, Ohio 44195,
USA
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Article ID: 100067Z10JS2020
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Son J, Das D, Connor E, Pannunzio A, Michener CM. Common cancer, puzzling presentation: A report of endometrial cancer presenting as an obstructive duodenal mass. J Case Rep Images Oncology 2020;6:100067Z10JS2020.ABSTRACT
The risk of extrauterine spread in endometrial cancer depends on the histologic type and grade. Metastatic endometrial cancer typically follows a predictable pattern of spread, favoring the lymphatic route. We report an unusual case of a patient with International Federation of Gynecology and Obstetrics (FIGO) grade 2 endometrioid endometrial cancer who presented with an obstructive duodenal mass with no other preoperative evidence of disease. Available diagnostic data suggested a possible second primary cancer. Upon entering the abdomen, it became apparent that the duodenal mass was a metastatic focus. The final pathology revealed a high-grade serous component. Underestimation of endometrial biopsy, failure of diagnostic imaging, and the nonspecificity of fine needle aspiration led to diagnostic difficulty. Staging laparoscopy may be useful in such cases.
Keywords: Duodenal mass, Metastatic endometrial cancer, Staging laparoscopy
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Author Contributions
Ji Son - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Deepanjana Das - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Elizabeth Connor - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Andrea Pannunzio - Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Chad M Michener - Conception of the work, Design of the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementBecause the patient is now deceased, written informed consent was obtained from the patient’s next-of-kin, her husband, for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Ji Son et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
