Palliative segmental duodenectomy for bleeding, erosive endometrial cancer.
BACKGROUND
Endometrial cancer is the fourth most common malignancy among women. Metastases typically involve the lungs, peritoneal surfaces of the abdominal cavity, and lymph nodes outside the pelvis.


METHODS
We report an unusually difficult complication of metastatic endometrial cancer occurring in a 57 year-old woman with paraaortic nodal recurrence: refractory occult gastrointestinal bleeding. Repeated upper endoscopic evaluation revealed an extrinsic mass eroding into the third portion of the duodenum. Segmental duodenal resection was performed, and the GI tract was reconstructed with a side-to-side duodenojejunostomy. The postoperative course was uneventful, and the patient experienced durable relief from continued bleeding and impending obstruction.


CONCLUSIONS
We review the role of palliative surgery for bleeding complications of advanced cancer and the alternatives for treating invasive extrinsic lesions of the duodenum.
Schneider
James J
JJ
Department of Surgery, Division of Surgical Oncology, University of Pittsburgh School of Medicine, 497 Scaife Hall, Pittsburgh, PA 15261, USA.
Shroff
Sahir
S
Moser
A James
AJ
D013505:Digestive System Surgical Procedures / Q000379:methods; D004379:Duodenal Neoplasms / Q000556:secondary / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*