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Case Reports
. 2018 Apr 5;7(2):71-75.
doi: 10.1007/s13691-018-0323-4. eCollection 2018 Apr.

Successful radiotherapy for endometrial serous carcinoma with local repeated recurrence

Shinya Kusumoto  1 , Hisaya Fujiwara  1 , Maiko Sagawa  1 , Takahiro Nobuzane  1 , Toshihiro Nishida  2 , Yukio Akagi  3 , Yutaka Hirokawa  3 , Yasuhiro Katsube  1
Affiliations
Case Reports

Successful radiotherapy for endometrial serous carcinoma with local repeated recurrence

Shinya Kusumoto et al. Int Cancer Conf J. .

Abstract

The incidence of endometrial serous carcinoma (ESC) has been increasing, and ESC is resistant to treatment. We report a patient with ESC who responded to radiotherapy for multiple recurrences. The first recurrence was detected in the vaginal wall and left internal iliac lymph node 5 months after the initial treatment. Concurrent chemoradiotherapy (CCRT) was administered. Radiation was delivered using the intensity modulated radiation therapy technique. The second recurrent tumor was detected in the right internal iliac lymph node after 4 months, and CCRT was conducted. After 4 months, the third recurrence was detected in the right common iliac node, and CCRT was performed. After 8 months, the fourth recurrence was detected in the horizontal portion of the duodenum, and radiotherapy was administered. After 9 months, the fifth recurrence was detected in the vaginal wall. Interstitial brachytherapy was conducted. Grade 2 gastrointestinal injury, nausea and radiodermatitis were observed. During the subsequent 13-month follow-up, there has been no recurrence. Although ESC is resistant to treatment, radiotherapy could be effective in some cases. Even when multiple recurrences occur, radiotherapy may be considered a treatment option if the irradiation level is permissible.

Keywords: Complete remission; Endometrial serous carcinoma; Intensity modulated radiation therapy; Multiple recurrence.

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Figures

Fig. 1
Fig. 1
Sagittal T2-weighted MRI findings. The thickened and uneven endometrium lining was observed. MRI magnetic resonance imaging
Fig. 2
Fig. 2
a The size of the resected tumor was 60 mm. b The cancer had spread into the inner half of the myometrium (triangles), and perimetrium metastases were observed (arrows). c The histologic type was endometrial serous carcinoma
Fig. 3
Fig. 3
FDG-PET shows accumulation at the vaginal wall (a) and left internal iliac lymph node (b). FDG-PET fluorodeoxyglucose positron emission tomography
Fig. 4
Fig. 4
a Dose distribution of first IMRT. b Dose volume histogram of the small intestine, rectum, bladder and planning target volume. IMRT intensity modulated radiation therapy
Fig. 5
Fig. 5
Dose distribution of IMRT. a Second IMRT. b Third IMRT. c Fourth IMRT. IMRT intensity modulated radiation therapy
See this image and copyright information in PMC

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