Journal article
Tibial bone metastasis as an initial presentation of endometrial carcinoma diagnosed by fine-needle aspiration cytology: A case report and review of the literature
CytoJournal, Vol.12(1), p.11
01/01/2015
DOI: 10.4103/1742-6413.157507
PMCID: PMC4453162
PMID: 26085835
Abstract
Endometrial cancer is the most common gynecologic malignancy in the United States. However, bony metastasis is infrequent and exceptionally rare as the initial presentation. We report a case of a 77-year-old female with a clinically silent endometrial carcinoma who presented with a left tibial metastasis as the first manifestation of her disease. Ours is only the third case diagnosed by fine-needle aspiration (FNA) cytology, and the first to detail the cytomorphologic features of metastatic endometrial cancer to bone. These microscopic findings, including three-dimensional cohesive clusters with cellular overlapping and cuboidal to columnar cells exhibiting low nuclear: cytoplasmic ratios and partially vacuolated cytoplasm, differ significantly from those of endometrial carcinoma on a Papanicolaou test. The tumor bore similarity to the more commonly encountered metastatic colon cancer, but immunohistochemical staining enabled reliable distinction between these entities. A review of osseous metastases of endometrial cancer demonstrates a predilection for bones of the lower extremity and pelvis with a predominance of the endometrioid histologic subtype. In about a quarter of the cases, the bony metastasis was the first manifestation of the cancer. FNA was an effective diagnostic modality for this unusual presentation of a common malignancy. Awareness of this entity and its differential diagnosis is essential for accurate and timely diagnosis.
Details
- Title: Subtitle
- Tibial bone metastasis as an initial presentation of endometrial carcinoma diagnosed by fine-needle aspiration cytology: A case report and review of the literature
- Creators
- Sarag Aboujafar Boukhar - Address: Department of Pathology, University of Hawaii, Honolulu, HI, United StatesRicky Kaneshiro - Address: Department of Pathology, University of Hawaii, Honolulu, HI, United StatesAlan Schiller - Address: Department of Pathology, University of Hawaii, Honolulu, HI, United StatesKeith Terada - Department of Obstetrics and Gynecology, University of Hawaii, Honolulu, HI, United StatesPamela Tauchi-Nishi - Address: Department of Pathology, University of Hawaii, Honolulu, HI, United States
- Resource Type
- Journal article
- Publication Details
- CytoJournal, Vol.12(1), p.11
- Publisher
- Medknow Publications & Media Pvt Ltd; India
- DOI
- 10.4103/1742-6413.157507
- PMID
- 26085835
- PMCID
- PMC4453162
- ISSN
- 0974-5963
- eISSN
- 1742-6413
- Language
- English
- Date published
- 01/01/2015
- Academic Unit
- Pathology
- Record Identifier
- 9984047621302771
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