[Gastrointestinal bleeding of obscure origin caused by a metastatic endometrial adenocarcinoma. Response to hormonal therapy].
BACKGROUND
Endometrial cancer (EC) is the most common gynecologic malignancy. Gastrointestinal tract involvement is unusual and is often limited to local invasion of the rectum in advanced disease.


METHODS
We report the case of a 77-year-old woman who presented with intermittent gastrointestinal bleeding 2 years after treatment of stage IIb EC. Biopsy of a subcutaneus nodule showed fibroadipose tissue infiltrated by an EC. A computed tomography scan showed extensive lymphatic, abdominal and pelvic recurrence of the cancer. A source of bleeding in the small bowel was detected by scintigraphic study with 99mTc-marked red blood cells. Control of bleeding and a 22-month survival were obtained after treatment with oral medroxyprogesterone acetate.


CONCLUSIONS
We review digestive tract involvement in EC and previously published data on small bowel metastases. We also review the role of hormone therapy in the management of this disease.
Ibáñez Pinto
Alberto
A
Servicio de Aparato Digestivo. Hospital Montecelo. Complejo Hospitalario de Pontevedra. Pontevedra. España. carthagoo@hotmail.com
Fernández Salgado
Estela
E
Castro Ortiz
Elena
E
Baltar Arias
Ruth
R
Vázquez Vázquez
Sergio
S
Ledo Barro
Luis
L
Vázquez San Luis
Javier
J
Vázquez Astray
Enrique
E
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D018269:Carcinoma, Endometrioid / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008207:Lymphatic Metastasis; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D014057:Tomography, X-Ray Computed; D014472:Umbilicus / Q000473:pathology
D018931:Antineoplastic Agents, Hormonal; D017258:Medroxyprogesterone Acetate