Abstract
Extragenital malignant tumors rarely metastasize to the uterus, of these in Japan, metastasis from stomach cancer to the uterus is relatively common. This paper deals with our experience with metastasis of pancreatic cancer to the uterus, with some bibliographic comments. The case involved a 68-year-old woman who, in the course of cytodiagnosis of the uterine mucosa, was found to have a class V probability of cancer. She was due to undergo hysterectomy, but a blood sample revealed a high value of the tumor marker CA19-9. The gynecologist referred her to us. Upon performance of an abdominal CT scan, a low density tumor about 3cm in diameter was found in the pancreas tail and a MRI (sagittal section) revealed an about 3-cm diameter hypointense tumor in the muscle layer of the uterine tail on T2-weighted images. Suspecting pancreatic and uterine cancer, we performed excisions of the pancreatic body and tail, spleen, transverse colon, and left adrenal gland, as well as total hysterectomy. The histopathology revealed that the pancreatic tumor was invasive pancreatic ductal carcinoma (including differentiated tubular adenocarcinoma) and was neuroinvasive. The uterine tumor presented the same lesion as the pancreatic cancer, indicating that tubular adenocarcinoma had invaded extensively from the uterine mucosa to the serous membrane. Accordingly, we diagnosed the case as metastasis of the pancreatic cancer to the uterus. For adjuvant chemotherapy, gemcitabine was administered intravenously, but on the 259th day of illness the patient passed away from lymphangiosis carcinomatosa.
