Inguinal Lymph Node Metastasis Presenting As a Delayed Site Metastasis in a Case of Early Endometrial Carcinoma.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 9
Abstract
Introduction: Obturator lymph nodes and external iliac nodes are the most common lymph nodes involved in carcinoma endometrium. Less than 5% of the cases with endometrial cancer present as stage IV disease with inguinal lymph node metastasis being 0.38%. Case Report: We report a case of 62 year-old female, post-operative case of ca endometrium with left inguinal swelling since 3 months. MRI of the pelvis revealed 39mm*28mm*24mm nodular subcutaneous lesion in the left inguinal region. Biopsy from the mass reported as metastatic adenocarcinoma with the origin from endometrium. The patient underwent superficial and deep inguinal lymph node dissection. Histo-pathology reported as metastatic carcinoma with peri nodal infiltration. Immunohistochemistry were positive for CK7, PAX-8, Oestrogen and progesterone receptor Discussion: The risk of recurrence in low grade endometrial cancer is less than 3% with majority of them occurring in the first 3 years. Inguinal lymph node metastasis in early endometrial cancer is rare with five cases reported so far. Due to rarity of this scenario, the impact of inguinal LND followed by Post-Operative Radiation Therapy (PORT) in addition to hormonal therapy on the survival in these patients is not well known. Further studies need to be carried out before we can standardise the management in such cases Conclusion: Inguinal lymph node metastasis as a delayed site of occurrence in a case of endometrial carcinoma is a rare phenomenon. However the efficacy of inguinal lymph node dissection with post-operative radiation and adjuvant hormonal treatment in terms of survival benefit needs further assessment.
Authors and Affiliations
Dr. Nitesh R. Maurya
Keywords
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