ENDOMETRIAL CARCINOMA PRESENTING WITH AN ISOLATED OSSEOUS METASTASIS - A CASE-REPORT AND REVIEW OF THE LITERATURE

Endometrial carcinoma, the fourth most common cancer in women, is prim arily a disease afflicting postmenopausal women and usually presents w ith vaginal bleeding or vaginal discharge. A slender, athletic 44-year -old woman was diagnosed with endometrial carcinoma after presenting w ith an isolated, solitary femoral bone metastasis. She had no symptoms except for progressive left knee pain. An open biopsy of the lesion i n the proximal left femur revealed metastatic adenocarcinoma compatibl e with an endometrial primary. An endometrial biopsy subsequently reve aled moderately differentiated endometrioid adenocarcinoma. The patien t underwent total abdominal hysterectomy and bilateral salpingo-oophor ectomy, and adjuvant chemotherapy. An aggressive metastatic workup rev ealed no other sites of metastatic disease. The femoral metastasis was treated with radiation. On chronic progestin therapy, the patient is clinically free of disease 2 years following diagnosis. Patients with endometrial carcinoma (with otherwise early stage disease) who present with an isolated skeletal lesion may represent an unusual group with perhaps a better prognosis. This patient revealed aggressive multi-dis ciplinary therapy and has had a two year progression-free interval.