title: Endometrial adenocarcinoma without myometrial invasion metastasizing to the pancreas and masquerading as primary pancreatic neoplasm.
abstract: Reported herein is a case of endometrial adenocarcinoma without myometrial invasion that metastasized to the pancreas in a 69-year-old Japanese woman who had a history of hysterectomy. Although systemic radiography could not detect any metastasis in the whole body before hysterectomy, imaging performed 2 months after the hysterectomy consisting of CT, magnetic resonance imaging, gallium scintigraphy and positron emission tomography identified a solitary pancreatic tumor. Imaging demonstrated an intracystic papillary growth in the pancreas, suggesting intraductal papillary mucinous neoplasm or mucinous cystic neoplasm. Excised in distal pancreatectomy, the tumor was diagnosed as a pancreatic primary, an invasive papillary adenocarcinoma at first, but both the endometrial tumor and the pancreatic tumor demonstrated similar morphology and immunohistochemistry. Furthermore, the identical nucleotide mutation of TP53 gene was observed from both the endometrial and pancreatic tumors. The pancreatic tumor was therefore confirmed to be a metastasis from the primary endometrial adenocarcinoma. Metastasis to the pancreas from endometrial carcinoma is extremely rare but must be considered even if the previous cancer was treated at an early stage. Histopathological comparison study and genetic analysis are important for the correct diagnosis of metastasis.
authors.affiliation: Department of Pathology, Yokohama City University Hospital, Yokohama, Japan. oshiroh@yokohama-cu.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Oshiro
authors.forename: Yohei
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Arai
authors.forename: Mikiko
authors.initials: M
authors.lastname: Asai-Sato
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakayama
authors.forename: Shoji
authors.initials: S
authors.lastname: Yamanaka
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inayama
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Fukushima
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000556:secondary* / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000473:pathology; D000231:Adenocarcinoma, Papillary / Q000473:pathology; D000368:Aged; D001483:Base Sequence; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D005260:Female; D016158:Genes, p53; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D008969:Molecular Sequence Data; D009154:Mutation; D010190:Pancreatic Neoplasms / Q000235:genetics / Q000556:secondary* / Q000601:surgery