SHM Converge Scientific Abstract ePoster Gallery-Pulmonary Metastasis From Endometrial Carcinoma a Decade After Complete Remission

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This case report describes a 64-year-old woman with a history of high-grade endometrial carcinoma who developed new pulmonary nodules 10 years after completing treatment and remaining in remission. Her original cancer had been treated with hysterectomy, bilateral salpingo-oophorectomy, paraaortic lymph node dissection, six cycles of carboplatin and paclitaxel, and vaginal brachytherapy. She then had a decade of negative surveillance imaging and no tumor marker elevation.<br /><br />On a surveillance PET scan, two lung nodules were detected in the right lower lobe and left upper lobe. Fine needle aspiration of the larger nodule suggested recurrent endometrial carcinoma, supported by similar immunohistochemical staining. Because of the poor prognosis of recurrent disease, she enrolled in a clinical trial and received carboplatin, paclitaxel, and pembrolizumab/placebo. After three cycles, CT imaging showed a reduction in the size of the pulmonary nodules.<br /><br />The report emphasizes that pulmonary metastasis from endometrial carcinoma is uncommon, with the lung representing a rare metastatic site. Although most recurrences occur within three years of primary treatment, late recurrence can occur even after a long period of remission. Therefore, lung lesions in patients with a prior history of uterine cancer should raise suspicion for metastatic disease.<br /><br />The authors also review that endometrial carcinoma is the second most common gynecologic cancer worldwide, and advanced or recurrent disease has limited treatment options. Standard first-line therapy is carboplatin and paclitaxel, while pembrolizumab has shown activity in MSI/MMR-related disease.<br /><br />Overall, the case highlights the importance of long-term vigilance in endometrial cancer survivors and the need to consider metastatic recurrence in the differential diagnosis of new pulmonary nodules.

Asset Subtitle

Lavleen Kaur

Meta Tag

Author List Lavleen Kaur, Lekha Yadukumar, Mashu Shrivastava, Nirali Patel, Udit Asija

Category Clinical Vignettes

Concept Metastatic Recurrence

Concept Endometrial Adenocarcinoma

Concept Pulmonary Nodules

Concept Pulmonary Metastasis

Concept Recurrent Endometrial Carcinoma

Distinguished Non-Finalist

Presenter Organization The Wright Center for GME

Presenting Author Lavleen Kaur

Track Adult

Keywords

endometrial carcinoma

pulmonary nodules

late recurrence

lung metastasis

surveillance PET scan

fine needle aspiration

carboplatin paclitaxel

pembrolizumab

gynecologic cancer

metastatic disease

Metastatic Recurrence

Endometrial Adenocarcinoma

Pulmonary Nodules

Pulmonary Metastasis

Recurrent Endometrial Carcinoma