Intracranial and scalp metastasis of endometrial carcinoma

Background:    Endometrial adenocarcinoma is one of the most common gynecological tumors in postmenopausal women. The distant metastasis mostly involves liver, lung and bone. Scalp metastases from endometrial adenocarcinoma are very rare.
    Case Report:    A 63-year-old female with history of irregular vaginal bleeding presented with progressive headaches and a rapidly enlarging mass on the left forehead. There were no other associated symptoms including any motor or sensory deficits. MRI of the head showed a large 8cm tumor extending from the left frontal subcutaneous tissue through the skull into the epidural space. CT scan of the abdomen, pelvis and thorax revealed a uterine mass and showed multiple signal abnormalities in the ribs and vertebra indicative of metastasis. The patient underwent craniotomy and also had an endometrial biopsy. Both craniotomy and endometrial biopsies revealed endometriod adenocarcinoma.
    Conclusions:    This case illustrates that although scalp or intracranial metastases from endometrial adenocarcinoma are very rare, it must remain in the differential diagnosis in an elderly woman with dysfunctional uterine bleeding and a scalp tumor.

Keywords: Neoplasm Metastasis -- diagnosis, Neoplasm Metastasis -- pathology, Neoplasm Metastasis -- prevention & control, Neoplasm Metastasis -- radiography, scalp and intracranial metastases, endometrial adenocarcinoma, Brain Neoplasms - secondary, Carcinoma, Endometrioid - pathology, Diagnosis, Differential, Endometrial Neoplasms - pathology, Head and Neck Neoplasms - secondary, Neoplasm Metastasis, Skin Neoplasms - secondary