Endometrial Karsinomdan Kaynaklanan İzole Dalak Metastazı: Olgu Sunumu

Abstract

Endometrial kanser, kadın üreme sisteminin en yaygın malignitesidir. Ancak, dalak metastazı, dalağın özgün anatomik ve mikroçevresel özellikleri olması nedeniyle son derece nadir bir durumdur. Bu vaka raporunda, endometriyal karsinom tanısı almış, total histerektomi, bilateral salpingo-ooferektomi, pelvik peritonektomi, omentektomi yapılmış ve intraoperatif dalak metastazı tespit edildikten sonra splenektomi uygulanan, 66 yaşındaki bir kadın hasta sunulmaktadır. Histopatolojik incelemede Ki-67 proliferasyon indeksi %90 olan, yüksek dereceli seröz karsinom saptanmış olup, metastatik olarak over, periton ve dalak tutulumu doğrulanmıştır. Hastaya, adjuvan karboplatin-paklitaksel kemoterapisi, radyoterapi ve hastalık progresyonu nedeniyle çoklu basamak sistemik tedavi verilmiştir. Çok basamaklı kemoterapide önemli bir yan etki gözlenmedi. Bu olgu, endometriyal karsinomun nadir görülen splenik metastazındaki tanısal zorlukları ve tedavi stratejilerini ortaya koymaktadır.

Keywords

• endometrial karsinom
• metastaz
• dalak

Isolated Synchronous Splenic Metastasis from Endometrial Carcinoma: Case Report

Abstract

Endometrial carcinoma is the most prevalent malignancy of the female reproductive system. However, splenic metastasis remains an infrequent occurrence due to the spleen's distinct anatomical and microenvironmental characteristics. This case report described a 66-year-old female patient diagnosed with endometrial carcinoma, who underwent total hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy, omentectomy, and splenectomy following the intraoperative detection of splenic metastasis. The histopathological evaluation confirmed high-grade serous carcinoma with a Ki-67 proliferation index of 90%, as well as metastatic involvement of the ovaries, peritoneum, and spleen. The patient subsequently received adjuvant carboplatin-paclitaxel chemotherapy, radiotherapy, and multiple-step systemic therapy due to disease progression. No significant adverse effects were observed in multi-step chemotherapy. The present case demonstrates the diagnostic challenges and treatment strategies encountered in a rare occurrence of endometrial carcinoma with splenic metastasis.

Keywords

• endometrial carcinoma
• metastasis
• spleen

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