Stage IVB uterine endometrial cancer successfully salvaged by chemoradiotherapy and surgery

A case of stage IVB adenoacanthoma of the uterine corpus is described. The patient was admitted with a large amount of atypical genital bleeding. Computed tomography and magnetic resonance imaging revealed a large tumor accompanied by lymph node involvement in the left inguinal, multiple pelvic, and paraaortic regions. She was diagnosed as having stage IVB endometrial adenoacanthoma. Neoadjuvant chemotherapy with carboplatin (CBDCA) and 5-fluorouracil (5-FU) was performed, followed by radiotherapy. The tumor responded very well, but still remained in Douglas' pouch after treatment. The patient therefore underwent a simple hysterectomy, pelvic and paraaortic lymphadenectomy, and partial rectal resection. Histopathologically, viable cancer cells were observed only in the fundus of the uterus. The patient is alive with no evidence of recurrence 4 years after the initiation of chemoradiotherapy.