Isolated muscle metastasis from early-stage endometrial carcinoma six years after diagnosis: A case report and literature review

Abstract

INTRODUCTION AND IMPORTANCE: Endometrial cancer is the most common gynecological malignancy, typically diagnosed at an early stage with a favorable prognosis. However, certain subtypes and molecular characteristics can predispose patients to a higher risk of recurrence and metastasis. Understanding unusual metastatic patterns, such as isolated muscular metastases, is crucial for comprehensive management and treatment strategies in endometrial cancer. CASE PRESENTATION: A 55-year-old woman with a previous diagnosis of grade 2 intra-mucosal endometrioid adenocarcinoma presented with a painful abdominal swelling. Imaging identified a parietal formation within the rectus abdominis muscle, initially suspected to be an endometriotic cyst. Subsequent surgical excision confirmed the presence of carcinomatous glands infiltrating the striated muscle tissue. After a complication-free surgery, the patient underwent adjuvant chemotherapy and is now being monitored for 10 months without any signs of recurrence. CLINICAL DISCUSSION: The presented case underscores the rarity of muscular metastases in endometrial cancer, emphasizing the need for better understanding and awareness of unusual metastatic patterns. Detailed histological examination confirmed the secondary parietal muscular localization of the carcinoma, prompting further therapeutic management. CONCLUSIONS: This case contributes to the existing literature by highlighting a unique presentation of metastatic endometrial cancer in the muscular tissue, shedding light on potential diagnostic challenges and treatment considerations. Enhanced awareness and knowledge of such atypical metastatic sites are crucial for improved patient care and outcomes.