title: Unusual Presentation of Recurrent Early Stage Endometrial Carcinoma 28 Years after Primary Surgery.
abstract: Endometrial carcinoma is the most common neoplasia of female genital tract. The prognosis of early stage disease (FIGO I and FIGO II) is excellent: recurrence after surgery is less than 15%, most of which are reported within 3 years after primary treatment. Herein we report a case of late rectal recurrence from FIGO Ib endometrial adenocarcinoma. Patient had also familiar and personal history of colonic adenocarcinoma and previous findings of microsatellite instability (MSI); molecular analysis evidenced heterozygotic somatic mutation in MLH1 gene. Twenty-eight years after hysterectomy and bilateral salpingoovariectomy, a rectal wall mass was detected during routine colonoscopy. Patients underwent CT scan, pelvic MRI, and rectal EUS with FNA: histopathological and immunohistochemical analysis revealed differentiated carcinoma cells of endometrial origin. No neoadjuvant treatment was planned and low rectal anterior resection with protective colostomy was performed; histology confirmed rectal lesion as metastasis from endometrial carcinoma. Recurrence of early stage endometrial carcinoma after a long period from primary surgery is possible. It is important to keep in mind this possibility in order to set a correct diagnostic and therapeutic algorithm, including preoperative immunohistochemical staining, and to plan a prolonged follow-up program.
authors.affiliation: 4th General Surgery Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Franchello
authors.affiliation: 4th General Surgery Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Gianruggero
authors.initials: G
authors.lastname: Fronda
authors.affiliation: 4th General Surgery Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Deiro
authors.affiliation: 4th General Surgery Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Fiore
authors.affiliation: 4th General Surgery Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Cassine
authors.affiliation: 2nd Phathological Anatomy Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Molinaro
authors.affiliation: 2nd Phathological Anatomy Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Chiusa
authors.affiliation: 4th General Surgery Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Galati
authors.affiliation: 4th General Surgery Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Resegotti
authors.affiliation: 4th General Surgery Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Silvestri