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. 2023 Mar 10;12(3):168-172.
doi: 10.1007/s13691-023-00599-6. eCollection 2023 Jul.

A case of solitary lymph node recurrence 9 years after initial treatment for advanced premenopausal endometrioid endometrial cancer; clinical usefulness of hormonal replacement therapy

Maaya Ono  1 , Koji Yamanoi  1 , Asuka Okunomiya  1 , Yusuke Sagae  1 , Haruko Okamoto  1 , Masumi Sunada  1 , Mana Taki  1 , Masayo Ukita  1 , Yoshitsugu Chigusa  1 , Akihito Horie  1 , Ken Yamaguchi  1 , Junzo Hamanishi  1 , Masaki Mandai  1
Affiliations

A case of solitary lymph node recurrence 9 years after initial treatment for advanced premenopausal endometrioid endometrial cancer; clinical usefulness of hormonal replacement therapy

Maaya Ono et al. Int Cancer Conf J. .

Abstract

There is no consensus on the use of hormone replacement therapy (HRT) after treatment of advanced corpus cancer. We report a case of advanced corpus cancer at a young age, in which HRT was initiated 7 years after surgery, and regional lymph node recurrence was later detected. The patient was 35 years old at the time of initial treatment in X year, when she was diagnosed with stageIIIC2 corpus cancer and underwent a hysterectomy with bilateral salpingo-oophorectomy and a retroperitoneal lymphadenectomy. HRT was started at X + 7 years, and at X + 9 years, a 25 × 12-mm-sized mass was found in the hilum of the right kidney. A laparoscopic resection revealed regional lymph node recurrence of the corpus cancer. A retrospective study further revealed that a tumor measuring 12 × 3 mm was found at X + 3 years and grew to 18 × 7 mm in X + 6 years, just before the start of the HRT. We hypothesize that HRT did not induce tumor recurrence; instead, it allowed for long-term follow-up and early diagnosis.

Keywords: Advanced corpus cancer; Hormone replacement therapy; Late recurrence.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Pathological findings and images at initial treatment. a Microscopic findings of the uterus corpus. Cancer cells displayed a glandular architecture. Nuclear atypia was mild (× 100 magnification, bar equals 200 μm). b Immunohistochemistry (IHC) of estrogen receptor (ER). It is positive in cancer cells (× 100 magnification, bar equals 200 μm). c Microscopic findings of metastasis in obturator lymph node (× 100 magnification, bar equals 200 μm). d Microscopic findings of metastasis in para-aortic lymph node (× 100 magnification, bar equals 200 μm)
Fig. 2
Fig. 2
Images and pathological findings at treatment of recurrent tumor. a Image of computed tomography around the right renal hilum. Red arrow indicated the recurrent tumor between renal hilum and IVC. b Image of magnetic resonance imaging. Enhance-contrasted T1-weighted image. Red arrow indicated the recurrent tumor between renal hilum and IVC. c–h Microscopic findings of recurrent tumor (× 100 magnification, bar equals 200 μm). c Cancer cells displayed a glandular architecture, surrounded by lymph node structure. d Immunohistochemistry (IHC) of estrogen receptor (ER). Partialy positive in cancer cells. e IHC of MSH2. Complete loss in cancer cells. f IHC of MSH6. Complete loss in cancer cells. g IHC of MLH1. Expression is retained in cancer cells. h IHC of PMS2. Expression is retained in cancer cells
Fig. 3
Fig. 3
Retrospective study of recurrent tumor from the end of initial treatment to just before the identification of tumor recurrence. Two years after the initial treatment, the presence of tumor was confirmed, and there was a trend toward gradual enlargement over the years
See this image and copyright information in PMC

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