[Gastrointestinal bleeding of obscure origin caused by a metastatic endometrial adenocarcinoma. Response to hormonal therapy]

Gastroenterol Hepatol. 2007 Nov;30(9):530-4. doi: 10.1157/13111689.
[Article in Spanish]

Abstract

Background: Endometrial cancer (EC) is the most common gynecologic malignancy. Gastrointestinal tract involvement is unusual and is often limited to local invasion of the rectum in advanced disease.

Case report: We report the case of a 77-year-old woman who presented with intermittent gastrointestinal bleeding 2 years after treatment of stage IIb EC. Biopsy of a subcutaneus nodule showed fibroadipose tissue infiltrated by an EC. A computed tomography scan showed extensive lymphatic, abdominal and pelvic recurrence of the cancer. A source of bleeding in the small bowel was detected by scintigraphic study with 99mTc-marked red blood cells. Control of bleeding and a 22-month survival were obtained after treatment with oral medroxyprogesterone acetate.

Discussion: We review digestive tract involvement in EC and previously published data on small bowel metastases. We also review the role of hormone therapy in the management of this disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Carcinoma, Endometrioid / complications
  • Carcinoma, Endometrioid / diagnostic imaging
  • Carcinoma, Endometrioid / drug therapy
  • Carcinoma, Endometrioid / secondary*
  • Carcinoma, Endometrioid / therapy
  • Combined Modality Therapy
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / therapy
  • Female
  • Gastrointestinal Hemorrhage / etiology*
  • Humans
  • Lymphatic Metastasis
  • Medroxyprogesterone Acetate / therapeutic use*
  • Pelvic Neoplasms / diagnostic imaging
  • Pelvic Neoplasms / drug therapy
  • Pelvic Neoplasms / secondary*
  • Peritoneal Neoplasms / diagnostic imaging
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / secondary*
  • Retroperitoneal Neoplasms / diagnostic imaging
  • Retroperitoneal Neoplasms / drug therapy
  • Retroperitoneal Neoplasms / secondary*
  • Tomography, X-Ray Computed
  • Umbilicus / pathology

Substances

  • Antineoplastic Agents, Hormonal
  • Medroxyprogesterone Acetate