Advanced endometrial cancer with serous metastasis in a 17-year-old

Endometrial cancers with a component of serous histology generally occur in postmenopausal women and can present with advanced disease even in the absence of a deeply myoinvasive primary malignancy. We present a case of stage IIIC endometrial cancer with serous histology in a 17-year-old.

A 17-year-old presented with menorrhagia requiring blood transfusion and a transvaginal ultrasound demonstrated a 31 mm endometrial stripe within a bulky uterus. Endometrial curettage revealed a grade 2 endometrioid adenocarcinoma. The patient desired definitive surgical management for her disease; a stage IIIC endometrial cancer with focal low-grade serous carcinoma among a grade 2 endometrioid carcinoma was noted to be superficially myoinvasive. Multiple pelvic lymph nodes had evidence of metastatic serous adenocarcinoma. Platinum-based chemotherapy was administered, and the patient is without disease 24 months following therapy.

Advanced endometrial cancer with metastasis of serous carcinoma to the retroperitoneal lymph nodes can occur, albeit extraordinarily rarely, in very young women. This information is critically important when counseling a woman regarding conservative management of endometrial adenocarcinoma with the interest of preservation of her fertility.