PATTERNS OF PULMONARY METASTASIS FROM UTERINE-CANCER

Background: Endometrial cancer is the most common female genital cance r and approximately 90% of the cases are diagnosed while they are stil l confined to the uterus. However, the frequency and the pattern of pu lmonary metastasis (PM) have not been studied systematically. Patients and Methods: From 1962 to 1989, 90 patients wit PM were identified by computerized search of the medical records of the 1,550 (5.8%) patien ts admitted to the Massachusetts General Hospital with the diagnosis o f uterine cancer. The median age of the patients was 67 years (range f rom 42 to 88 years). The histology of the uterine neoplasms included 5 3 adenocarcinomas (59%), 19 sarcomas (21%), 12 adenosqamous carcinomas (13.5%), 4 adenoacanthomas (4.5%), and 2 clear cell adenocarcinomas ( 2%). Chest radiographs were retrospectively reviewed by two experience d readers. Results: Lung metastases were found at the time of diagnosi s of the primary tumor in 20 patients (22%). The usual pattern of PM i nvolved multiple pulmonary nodules in 65 patients (72%); solitary pulm onary nodules were found in 16 (18%), mass lesion in 10 (11%), lymphan gitic spread in 3, and pleural effusion in 6 (6.7%). Cavitation and tr acheal metastasis were observed in one case each. Conclusion: Pulmonar y metastases represent a common site of extrapelvic spread of disease for the small number of patients with advanced or recurrent endometria l carcinoma. The usual type of PM is multiple bilateral nodules.