Primary brain metastases of endometrial cancer: A report of 18 cases and review of the literature.
OBJECTIVE
To present a series of brain metastases from endometrial cancer (EC) and describe a comprehensive review of the literature.


METHODS
We retrospectively reviewed medical records of 1) patients with cerebral dissemination of EC treated at Mayo Clinic from 1984 to 2001 and 2) all patients referred for treatment of primary brain metastases after primary treatment for EC elsewhere. We also reviewed published case reports and case series describing cerebral spread of EC.


RESULTS
Among the 1632 patients treated at Mayo, 14 (0.86%) had primary brain dissemination; 4 additional referral cases were identified (total, 18 patients). In 2 cases (11.1%), diagnosis of brain metastases was made at presentation of EC; in the others, median time to development of brain metastasis was 5 (range, 1-57) months. Median survival was 57 (range, 7-118) months in patients with single cerebral metastases and no extracerebral involvement (n=6); for the remaining 12 patients, median survival was 4 (range, 0-28) months. Among the 6 patients with single brain metastases, complete surgical excision was possible in 5; in that group, the overall survival was 64 (range, 12-118) months. We identified 98 cases of brain metastases of EC in the literature: 58 were primary cerebral metastases. Overall survival after brain dissemination was significantly higher in patients with a single metastasis without other localization and receiving multimodal treatment including surgery and whole-brain radiotherapy.


CONCLUSIONS
Single primary brain metastases without extracerebral spread seem to have a relatively favorable prognosis. Aggressive multimodal treatment may include surgery and brain radiation.
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
Stefano
S
Uccella
Department of Radiology, Mayo Clinic, Rochester, MN, United States.
Jonathan M
JM
Morris
Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, United States.
Francesco
F
Multinu
Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, United States.
William A
WA
Cliby
Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, United States.
Karl C
KC
Podratz
Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, United States.
Bobbie S
BS
Gostout
Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, United States.
Sean C
SC
Dowdy
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
Fabio
F
Ghezzi
Faculty of Medicine, University of Aleppo, Syria.
Peter B
PB
Makdisi
Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, United States.
Gary L
GL
Keeney
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States; Department of Otorhinolaryngology Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States.
Michael J
MJ
Link
Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, United States. Electronic address: mariani.andrea@mayo.edu.
Andrea
A
Mariani
D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D011379:Prognosis; D012189:Retrospective Studies
Brain; Cerebral; Endometrial neoplasms; Neoplasm metastases; Prognosis