J Korean Soc Radiol.  2013 Oct;69(4):301-305. 10.3348/jksr.2013.69.4.301.

Imaging Findings of Endometrial Metastasis from Colon Cancer: A Case Report

• Kim N
• Park SB
• Lee JB
• Park HJ
• Kim MK
• Hwang IG
• Seok JW

• KMID: 2041951
• DOI: http://doi.org/10.3348/jksr.2013.69.4.301

Abstract

Metastasis to the uterus is thought to be a very rare condition, and few imaging findings have been reported in the English literature. Here, we describe a case of endometrial metastasis from colon cancer, which was depicted using gray-scale and Doppler ultrasonography, CT and positron emission tomography-CT, to be a smoothly lobulated heterogeneous, predominantly endometrial mass in the uterus with increased vascular flow.

MeSH Terms

Colon
Colonic Neoplasms
Electrons
Endometrium
Female
Neoplasm Metastasis
Ultrasonography, Doppler
Uterus

Figure

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  Fig. 1 Axial image of PET-CT shows a hypermetabolic lesion in the uterus (arrow, max-SUV: 13.2). The uterine lesion was thought to be due to a menstrual physiologic uptake, rather than true lesion. Note.-max-SUV = maximal standardized uptake value, PET-CT = positron emission tomography-CT

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  Fig. 2 Axial image of contrast-enhanced abdomen and pelvis CT scan shows heterogeneously enhancing lesion in the uterus (arrow). Lymph node enlargement is also noted in left external iliac area (not shown).

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  Fig. 3 Follow-up PET-CT scan after eight months. A. After eight months follow-up, whole-body PET-CT scan shows multiple hepatic metastases with newly developed hypermetabolic metastatic lesions in both lungs, multiple bones, lymph nodes (paraaortic and left pelvic lymph nodes), and peritoneum. B. Follow-up axial image of PET-CT shows the increased size of the hypermetabolic lesion in the uterus (arrow, max-SUV: 10.9), compared with previous PET-CT (Fig. 1). Note.-max-SUV = maximal standardized uptake value, PET-CT = positron emission tomography-CT

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  Fig. 4 Gray-scale and Doppler endovaginal US images. A. Gray-scale endovaginal US demonstrates a 4.0 × 1.4 cm, smoothly lobulated heterogeneous mass located predominantly in the uterine endometrium with endocervical extension (arrow). B. Doppler endovaginal US shows increased vascular flow within the mass (arrow). Note.-US = ultrasonography

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  Fig. 5 Photomicrograph of a histologic specimen from endometrial curettage showing gland-forming atypical cell infiltration with neoplastic glands adjacent to normal endometrial glands (hematoxylin-eosin, × 200). The histopathology findings were consistent with metastasis from colonic adenocarcinoma as identified from the previous hemicolectomy specimen. The immunohistochemical profile revealed positive staining for CK20 and negative for CK, which was strongly suggestive of colonic adenocarcinoma (not shown).

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