title: Anaplastic pelvic carcinoma secondary to low-grade endometrial carcinoma.
abstract: BACKGROUND
  Low-grade endometrial carcinoma has an excellent prognosis. The risk of secondary cancer after endometrial carcinoma is moderately increased and is mostly related to the field of postoperative radiation (small intestine, colon, vagina, and urinary bladder). Anaplastic (undifferentiated) pelvic carcinoma (APC) is rare and probably under-reported. To date, only one publication has reported six cases of APC that were secondary to low-grade endometrial carcinoma.
  
  
  METHODS
  We have analyzed the fulminant course of APC-preceded by paraneoplastic arthritis-four months after hysterectomy and adnexectomy for low-grade endometrial carcinoma (endometrioid type, moderately differentiated, tumor diameter: 2 cm, infiltration depth 3 of 15 mm). The 73-year-old patient died five weeks after the diagnosis of the second malignancy.
  
  
  CONCLUSIONS
  The prognosis of APC is poor and the limitations of the therapy result from aggressive tumor biology and rapid deterioration of the patients' general condition. Rheumatological symptoms can precede cancer diagnosis. Immunohistochemistry facilitates the differentiation between primary and secondary carcinoma.
authors.affiliation: Department of Gynecology and Obstetrics, St. Josefskrankenhaus, Teaching Hospital of the University of Freiburg, Sautierstr.1, 79104 Freiburg, Germany. saraband@gmx.net.
authors.forename: Rafal
authors.initials: R
authors.lastname: Watrowski
authors.forename: Jochen
authors.initials: J
authors.lastname: Möckel
authors.forename: Thorsten
authors.initials: T
authors.lastname: Venzke
authors.forename: Christoph
authors.initials: C
authors.lastname: Jäger
authors.forename: Thomas
authors.initials: T
authors.lastname: Bauknecht
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D060787:Neoplasm Grading; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010386:Pelvic Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011379:Prognosis
keywords: Anaplastic carcinoma; endometrial cancer; paraneoplastic arthritis; secondary cancer