Neoadjuvant Chemotherapy Followed by Radical Cytoreductive Surgery in Serous Endometrial Carcinoma With Inguinal...

Serous endometrial carcinoma is an aggressive histologic subtype of endometrial cancer associated with early dissemination and poor prognosis. Typical metastatic pathways involve pelvic and para-aortic lymph nodes as well as peritoneal surfaces, whereas metastasis to inguinal lymph nodes is extremely uncommon. We report the case of a 42-year-old woman diagnosed with serous endometrial carcinoma confirmed by histopathological and immunohistochemical evaluation of endometrial aspiration biopsy. Imaging revealed metastatic right inguinal lymph nodes measuring up to 21 mm without evidence of additional distant metastases. The patient received four cycles of neoadjuvant chemotherapy consisting of carboplatin and paclitaxel, followed by extensive cytoreductive surgery including radical hysterectomy (type C1), bilateral inguinal lymph node dissection, para-aortic lymphadenectomy up to the level of the left renal vein, and omentectomy. Final histopathological evaluation demonstrated no residual viable tumor, indicating a complete pathological response. At the 12-month follow-up, the patient remains disease-free with no evidence of recurrence. This case highlights the importance of individualized multimodal treatment strategies combining systemic chemotherapy and radical surgery in patients with aggressive histologic subtypes of endometrial carcinoma presenting with atypical metastatic patterns.