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Review
. 2023 Oct 30;17(1):451.
doi: 10.1186/s13256-023-04192-6.

Dedifferentiated endometrial carcinoma metastasis to axillary lymph node: a case report

Chase William Morrison  1 , Kayvon Nick Sanjasaz  1 , Saul David Nathanson  2 , Supriya Raina-Hukku  3 , David Matthew Pinkney  4 , Alexis Anna Davenport  4
Affiliations
Review

Dedifferentiated endometrial carcinoma metastasis to axillary lymph node: a case report

Chase William Morrison et al. J Med Case Rep. .

Abstract

Background: We present an unusual case of a left axillary lymph node metastasis from a primary dedifferentiated endometrial carcinoma. This pattern of metastasis is likely the result of circulating tumor cells reaching the node through its arterial blood supply.

Case presentation: In this report, a 68-year-old white woman with a dedifferentiated endometrial carcinoma underwent a hysterectomy. She later developed an enlarged axillary lymph node due to metastatic dedifferentiated endometrial carcinoma, treated with chemotherapy and anti-programmed cell death protein 1 immunotherapy resulting in a complete clinical and radiological response.

Conclusion: A review of the literature reveals the rarity of blood-borne lymph node metastasis, especially with uterine carcinoma. Immunotherapy has shown promising results in the treatment of some subtypes of metastatic uterine carcinoma.

Keywords: Axillary mass; Case report; Endometrial carcinoma; Immunotherapy; Metastatic carcinoma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A Uterus, full thickness section, 2 ×, hematoxylin and eosin (H&E) stain; tumor extensively infiltrating myometrium (outer half) with lymphovascular invasion. B Uterus, 40 ×, H&E stain; tumor composed of diffuse sheets of loosely cohesive neoplastic cells with areas of necrosis; nuclear pleomorphism, prominent nucleoli, and brisk mitoses are seen, consistent with dedifferentiated component of endometrial carcinoma
Fig. 2
Fig. 2
a Heterogeneously enhancing structure, suggesting recurrence, found at the anterior vaginal cuff on surveillance CT abdomen and pelvis status post-hysterectomy (arrow) b Transverse section of CT pelvis illustrating anterior vaginal cuff recurrence (arrow)
Fig. 3
Fig. 3
a Mammography of the left breast showing axillary LN enhancement (arrow) b Targeted ultrasound of the left breast showing hypoechoic regions in sagittal and transverse planes (arrows)
Fig. 4
Fig. 4
PET-CT showing intense hypermetabolic region in the left axillary LN, arrow illustrating metastatic endometrial carcinoma
Fig. 5
Fig. 5
A Axillary lymph node 4 ×; H&E stain: needle core biopsy with areas of viable tumor (left) and extensive necrosis (right) B Axillary lymph node 40 ×; H&E stain: tumor composed of loosely cohesive neoplastic cells with pleomorphic nuclei and prominent nucleoli brisk mitosis, similar to the dedifferentiated component of primary endometrial carcinoma
Fig. 6
Fig. 6
Mammogram status post-pembrolizumab with arrow showing resolution of mass where the metallic biopsy marker is present
See this image and copyright information in PMC

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