A case of lung metastasis from endometrial adenoacanthoma 17 years after initial treatment

In March 1982, a 60-old woman presented with an International Federation of Gynecology and Obstetrics grade 1, stage Ib endometrial adenoacanthoma, hi stological subtype of endometrial carcinoma. The patient underwent radical hysterectomy and was followed up for 10 years, without disease. In August 1 998, an abnormal shadow in the right lung was suggested on a chest X-ray fi lm at her routine health check-up and she came to our hospital for further evaluation. A thin-section computed tomographic scan of the chest suggested a malignant lung tumor, but the diagnosis remained tentative. Open biopsy was recommended, but the patient refused and was followed up on an outpatie nt basis. In November 1999, a thin-section computed tomographic scan of the chest revealed a slightly enlarged tumor and laboratory examination showed a high serum progastrin-releasing peptide concentration of 90.7 pg/ml. We performed partial resection of right upper lobe with video-assisted thoraci c surgery. Pathological examination confirmed the lung tumor had metastasiz ed from endometrial adenoacanthoma. Immunohistochemical stainings of estrog en receptor and progesterone receptor were positive both in the primary and lung tumor, only in the component of adenocarcinoma. After surgery, the se rum progastrin-releasing peptide concentration remained unchanged. The pati ent is currently alive and free of disease.