A case of uterine metastasis from cholangiocarcinoma

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  • NISHIMURA Hiroki
    Department of Gynecology, Cancer Institute Hospital of JFCR
  • UTSUGI Kuniko
    Department of Gynecology, Cancer Institute Hospital of JFCR
  • SUGIHARA Takeru
    Department of Gynecology, Cancer Institute Hospital of JFCR
  • HISA Tsuyosi
    Department of Gynecology, Cancer Institute Hospital of JFCR
  • OKAMOTO Sanshiro
    Department of Gynecology, Cancer Institute Hospital of JFCR
  • SUGIYAMA Yuko
    Department of Gynecology, Cancer Institute Hospital of JFCR Department of Cytological Diagnosis, Cancer Institute Hospital of JFCR
  • TAKAZAWA Yutaka
    Department of Pathological Diagnosis, Cancer Institute Hospital of JFCR
  • TAKESHIMA Nobuhiro
    Department of Gynecology, Cancer Institute Hospital of JFCR

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  • 胆管癌子宮転移の 1 例

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<p>Background : Most metastatic cancers involving the female genital organs usually affect the ovaries, whereas the uterus is rarely affected. A case of a cholangiocarcinoma with endometrial metastases is reported.</p><p>Case : A 77-year-old woman, G3P3, with a history of stage IVA cholangiocarcinoma at the age of 75 years was found to have a hyperplastic endometrium. Grade 1 endometrioid adenocarcinoma was diagnosed on endometrial cytology and endometrial biopsy. At the time of surgery, adhesion had occurred between the left side of the uterine body and the sigmoid colon, which was considered a neoplastic change. Hysterectomy, bilateral salpingo-oophorectomy, and low anterior resection of the rectum were performed. The postoperative pathologic diagnosis was metastatic endometrial cancer from a cholangiocarcinoma. The patient was treated with chemotherapy in the Department of Gastroenterology.</p><p>Conclusion : In previous reports, metastases from non-gynecologic organs to the uterus were much less common than ovarian metastases. In the present case, the possibility of uterine invasion from peritoneal dissemination of cholangiocarcinoma was considered. However, the cell morphology of metastatic cholangiocarcinoma resembles endometrioid adenocarcinoma, and the cytologist and pathologist were not told of the history of cholangiocarcinoma at the time of the preoperative examination, making preoperative diagnosis difficult. This case re-affirms the need to consider metastatic uterine cancer in patients with endometrial abnormalities who have a history of other organ cancer.</p>

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