A Rare Case of Rectal Cancer With Endometrial Metastasis: A Case Report

Background: Colorectal cancer (CRC) is ranked third in the world in incidence and cancer-related mortality. In this case report, we aimed to present a case of rectum cancer with endometrial metastasis which is rare in the literatüre.
Case report: On October, 2014; a 62-year-old woman was admitted to outer clinic with a complaint of rectal bleeding. In the colonoscopy, an ulcerovegetan mass was detected and biopsied. Biopsy pathology was reported as adenocarcinoma and the patient underwent a low anterior resection due to diagnosis of rectal cancer. The adjuvant therapy of the patient was completed and the patient was transferred to our clinic for follow-up. After adjuvant therapy, PET/CT examination was performed due to the fact that the sizes of nodules showed 20% increase according to RECIST criteria by thoracic tomography performed three months intervals. In PET / CT, hipermetabolic foci were detected in nodular lesions in the lung and within the uterine corpus. The patient's lung tru-cut biopsy and biopsy of the endometrial cavity was reported adenocarcinoma.
Conclusion: Approximately 20% of patients with CRC have distant metastasis at the time of diagnosis. In general, CRCs metastasize to regional lymph nodes, liver, lung, and less frequently to the bone, brain, and peritoneal cavity. The uterus, which is mostly composed of smooth muscle tissue, is rarely described as the metastatic region of extragenital cancers. Endometrium metastases of CRCs are cases in a limited number in the literature. We emphasize this case because of its rarity and beacuse of importance of differatial diagnosis of primary and metastatic tumors of the uterus.

Nadir Görülen Endometriyum Metastazlý Rektum Kanseri: Olgu Sunumu

Giriþ: Kolorektal kanser (KRK) insidans ve kansere baðlý mortalitede tüm dünyada 3. sýrada yer almaktadýr. Biz bu olgu ile literatürde nadir olan, endometriyum metastazlý rektum kanseri vakasýný sunmayý amaçladýk.
Olgu sunumu: 62 yaþýnda kadýn hasta 2014 yýlý Ekim ayýnda rektal kanama þikâyeti ile dýþ merkeze baþvurduðunda yapýlan kolonoskopisinde lümeni tama yakýn dolduran ülserovejetan kitle tespit edilmiþ ve biyopsi alýnmýþtý. Biyopsi patolojisi adenokarsinom ile uyumlu olarak raporlanmýþ ve hastaya rektum kanseri tanýsý ile low anterior rezeksiyon ameliyatý yapýlmýþtý. Hastanýn adjuvan tedavisi tamamlanmasýnýn ardýndan takibinin devamý için devir alýnmýþtý. 3 ay aralýklarla takibi yapýlan hastanýn kontrol tomografilerinde akciðer nodüllerinde RECIST kriterlerine göre %20’nin üzerinde boyut artýþý görülmesinden dolayý pozitron emisyon tomografisi (PET/CT) çekildi. PET/CT de akciðerdeki noduler lezyonlarda ve uterus korpusu içerisinde hipermetabolik odaklar tespit edildi. Hastaya akciðer nodüllerinden ve endometriyumdan biyopsi yapýldý. Hastanýn yapýlan akciðer tru-cut biyopsisi ve endometriyum küretaj biyopsisi metastatik adenokarsinom ( gastrointestinal sistem-kolon ile uyumlu) olarak raporlandý.
Tartýþma: KRK'lý hastalarýn yaklaþýk % 20'sinde taný anýnda uzak metastaz mevcuttur. Genel olarak, KRK’lar bölgesel lenf nodlarýna, karaciðere, akciðere ve daha az sýklýkla kemik, beyin ve periton boþluðuna metastaz yapar. Çoðunlukla düz kas dokusundan oluþan uterus, nadiren ekstragenital kanserlerin metastatik bölgesi olarak tanýmlanmaktadýr. KRK’larýn ise endometriyum metastazý geliþen vakalarý literatürde sýnýrlý sayýda mevcuttur. Biz bu vakayý hem nadir görülmesi hem de metastatik tümörler ile uterusun primer tümörlerinin ayýrýcý tanýsýnýn önemli olmasý nedeni ile vurguladýk.