Metástasis genital masiva de adenocarcinoma endometrioide de endometrio estadio IIIC2; a propósito de un caso clínico

Abstract

El cáncer endometrial es el tumor maligno más frecuente del tracto genital femenino, con una incidencia en continuo crecimiento y una tasa de mortalidad que se ha duplicado durante las últimas dos décadas. Generalmente, tiene buen pronóstico en los estadios precoces, sin embargo, alrededor de 10 % - 15 % presentan recidivas, la mitad de ellas limitadas a la vagina. La vulva representa un lugar muy infrecuente de recurrencia. El tratamiento del cáncer de endometrio es fundamentalmente quirúrgico, incluye histerectomía con salpingo-ooforectomía bilateral y el estudio de los ganglios linfáticos. No existe consenso sobre el valor terapéutico de la linfadenectomía sistemática, por lo que permanece siendo un punto de debate. Se presenta el caso de una paciente de 49 años, con diagnóstico de cáncer endometrial endometrioide, intervenida quirúrgicamente, quien a los 12 meses presenta una recidiva local en fondo vaginal, que acaba extendiéndose a toda la región vulvar.

Endometrial cancer is the most frequent malignant tumor of the female genital tract, with an incidence in continuous growth and a death rate that has doubled during the last two decades, reaching 10920 deaths in the year 2017 in the USA. Generally, endometrial cancer has a good prognosis in the early stages, however, about 10-15% present some type of recurrence, of which half are limited to the vagina. The vulva represents a very infrequent place of recurrence and its treatment is controversial, varying according to the histological type and extension of the lesions. The treatment of endometrial cancer is fundamentally surgical, including hysterectomy with bilateral salpingo-oophorectomy and the study of lymph nodes. However, there is currently no consensus on the therapeutic value of systematic lymphadenectomy, which remains a point of discussion. We present the case of a 49-year-old female patient, diagnosed with an endometrioid endometrial cancer surgically treated and who, 12 months after the intervention, presented a local recurrence in the vaginal fundus, which ends up extending to the entire vulvar region.