Reccurence in treated case of endometrial adenocarcinima

Reccurence in treated case of endometrial adenocarcinima

sayan paul 05 Dec 2010 05:30

56 year old post TAH endometrial adenoca treated in 2008 with PORT. had a brain mets in jan 2010 detected in PET CT ,Palliative RT to brain given with salvage CT pacli+carbo 6 cycle. Now in nov 2010 PET CT shows lung mets on left side single localized.Patient;s GC fair , KPS 90. No co morbidity , treated case of TB fallopian tube 20 years back . What should be the urther management ? can we give localized palliative RT to Lung .?

Re: Reccurence in treated case of endometrial adenocarcinima

Santam Chakraborty 05 Dec 2010 18:13

Hi sayan,
Palliative RT to the lungs I feel will be beneficial only if the patient is symptomatic from the lung metastasis. Since the patient is young and has a good KPS treatment should be pursued aggressively though with palliative intent. In absence of significant pulmonary comorbidity and a localized leison consideration should be given for a surgical excision as this is a single site of metastasis. The other alternative can be a SBRT of the leison if the patient is not a candidate for surgical excision or refuses a surgery. Palliative local RT can be given in situation where there is a large leison not amenable to resection or SBRT. So as you can see the location and size of the leison as well as her symptom status are important.
Having said that the tempo of the disease does suggest that disease is aggressive and likely to pop up somewhere else some months down the line. So a medical oncology consult would be worthwhile for a 2nd line CCT/ Hormonal option.
P.S. Was the histology reviewed? Can a FNAC from lung leison be obtained?

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Re: Reccurence in treated case of endometrial adenocarcinima

Nikhilesh Patil 05 Dec 2010 19:54

Agree with Santam, would like to know the initial histology and FIGO stage from 2008 ?

Re: Reccurence in treated case of endometrial adenocarcinima

sayan paul 15 Dec 2010 18:07

Sorry for being late . The initial histopath was adenoca Stage pT1c N0 M0. was treated outside with PORt. FNAC from lung mass was done in Delhi but the FNA material was not adequate to comment and they have advised repeat FNA ,