Right diaphragm metastasis of endometrial cancer: a case report

Our plain-English summary of Right diaphragm metastasis of endometrial cancer: a case report, by T. Zhang, X. Li, G. Liu, et al (The Journal of International Medical Research, 2020).

The study

• Authors: T. Zhang, X. Li, G. Liu, X. Chen, Y. Liu
• Journal: The Journal of International Medical Research
• Published: 2020;48(10):300060520961706
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A diaphragmatic tumor is usually caused by metastasis from lung cancer, malignant mesothelioma, and malignant thymoma. Endometrial cancer is rarely involved in metastasis to the diaphragm. A right anterior mediastinal tumor was found in a 60-year-old woman who was initially diagnosed with endometrial carcinoma. There was initially no relationship between the right anterior mediastinal tumor and endometrial carcinoma. Radical curative surgery was performed for endometrial carcinoma. The endometrial carcinoma stage was IA. The patient was admitted to the Department of Thoracic Surgery 6 months after the curative surgery. Intraoperative exploration showed a tumor growing in the right diaphragm. Right diaphragmotomy was performed. Immunohistochemistry showed metastasis of endometrial carcinoma to the diaphragm. Endometrial cancer solitary metastasis to the diaphragm is rare. Clinicians should be aware of this possibility. Surgical treatment followed by a pathological examination is the most useful method for determining the diagnosis of a diaphragmatic tumor due to metastasis of endometrial cancer.

In plain English

This article is a case report about one patient and does not concern asbestos. It mentions mesothelioma only as a usual source of diaphragm tumors. A 60-year-old woman was diagnosed with endometrial cancer (cancer of the lining of the womb). A chest scan also showed a separate tumor, apparently in the anterior mediastinum (front of the chest). Her womb, ovaries and tubes were removed in March 2019. It was a highly differentiated adenocarcinoma without pelvic lymph node spread. Because the chest tumor was then thought unlikely to be related, the cancer was staged pIA, and she received no adjuvant therapy. Six months later, surgeons found that the roughly 8 cm tumor had grown in the right diaphragm, not the mediastinum, and removed it with the invaded diaphragm. Laboratory staining showed it had spread from the endometrial cancer. At 16 months after the hysterectomy, there was no evidence of the cancer returning. The authors concluded that this kind of spread is rare and that surgery followed by pathological examination is the most useful way to diagnose it.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 60-year-old woman with endometrial cancer, treated in the Department of Thoracic Surgery at Peking University People's Hospital in 2019
• Exposure: No asbestos or other occupational exposure is described. The case concerns spread (metastasis) of endometrial cancer to the right diaphragm.
• Main results:
  • The endometrial cancer was removed by total hysterectomy with both appendages on 13 March 2019.
  • The primary tumor was a highly differentiated endometrial adenocarcinoma that invaded less than half of the uterine muscle wall. There was no spread to the pelvic lymph nodes.
  • At that time, the authors judged there was little possibility that the chest tumor was related to the endometrial cancer, and the endometrial cancer was staged pIA.
  • The initial stage assigned to the endometrial cancer was pIA.
  • The patient received no adjuvant therapy after the hysterectomy and was told to seek further treatment for the chest tumor.
  • Before the chest surgery, the CT scan could not easily distinguish an anterior mediastinal mass from a diaphragmatic mass.
  • At surgery six months after the hysterectomy, the tumor (about 8 cm) was found to have grown in the diaphragm rather than the mediastinum.
  • The tumor and the invaded diaphragm were completely removed.
  • Immunohistochemistry (estrogen receptor 20% positive, progesterone receptor 30% positive) confirmed that the diaphragm tumor was a metastasis from the endometrial carcinoma.
  • At 16 months after the total hysterectomy, there was no evidence of the tumor returning.
• The authors' conclusion: The authors concluded that solitary metastasis of endometrial cancer to the diaphragm is rare, that clinicians should be aware of it, and that surgical treatment followed by a pathological examination is the most useful method for making a diagnosis.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Diaphragm, Metastasis, Lung Cancer, Malignant Mesothelioma, Carcinoma, Thoracic Surgery, Immunohistochemistry.

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