CLINICAL STAGE IB ENDOMETRIAL ADENOCARCINOMA WITH AN ISOLATED SMALL-BOWEL METASTASIS

Although patients with widely disseminated endometrial adenocarcinoma can have tumor involving the intestine, a focal metastasis to the smal l, bowel with no other evidence of extrauterine spread has not been re ported. A patient with a clinical stage IB, grade 2 superficially inva sive endometrial adenocarcinoma was found to have an isolated distant metastasis to the small intestine. The patient has been asymptomatic a nd disease free for almost 4 years following postoperative treatment w ith whole abdominal radiation therapy on a Gynecologic Oncology Group protocol. The finding of a solitary small bowel metastasis was not pre dictable based on the current understanding of the biologic behavior o f endometrial adenocarcinomas. This case emphasizes the need for a tho rough abdominal exploration in patients with endometrial adenocarcinom a by surgeons trained to detect and resect abdominopelvic tumors, and it validates the need for innovative treatment protocols for women wit h gynecologic malignancies. (C) 1994 Academic Press, Inc.