2017 Volume 56 Issue 6 Pages 308-313
Background : Uterine metastasis from extrauterine malignant tumors is rare. In particular, there are few reports of uterine metastasis from gallbladder cancer. We report a case in which uterine metastasis from a malignant tumor was suspected from the findings on endometrial cytology.
Case : The patient was a 55-year-old female. She visited our hospital with the chief complaint of lower abdominal pain with atypical genital bleeding 2 years after the initial therapy for gallbladder cancer had been completed (operation and chemotherapy). MRI imaging examinations revealed an irregularly shaped tumor mass measuring 30 mm in diameter in the posterior myometrium, with intratumoral heterogeneity. Endometrial cytology revealed high columnar heterogeneous cells agglutinate with a long elliptical nuclei appeared in a clear background. Histopathological examination of the endometrium revealed coexisting atypical gland tissue and existing normal endometrial glands infiltrating the endometrium and myometrium. These features were different from those of typical endometrioid cancer, and the lesion was suspected as a metastasis from the gallbladder cancer. A laparotomy was performed for controlling the bleeding and for obtaining a definitive diagnosis. It revealed a tumor mass was occupying the pelvis that was adherent to the uterus and rectum in the pouch of Douglas, and total removal of the uterus was difficult.
Conclusion : Histological examination of the resected specimen revealed a features consistent with those of the previously treated gallbladder cancer, with the tumor cells infiltrating the endometrial stroma and myometrium. Immunostaining assay also revealed results consistent with those of the previously treated gallbladder cancer. Therefore, we diagnosed the lesion as a uterine metastasis from gallbladder cancer.
