Simultaneous Intratumoral Hemorrhage in Multiple Brain Metastases of Endometrioid Carcinoma: A Rare Presentation of A Rare Metastasis

Year 2023, Volume: 25 Issue: 3, 302 - 305, 30.12.2023

Sinan Bahadır

https://doi.org/10.18678/dtfd.1339016

Abstract

Metastasis of endometrioid carcinomas to the brain is rare, usually solitary, and has a poor prognosis. Intratumoral bleeding is also a poor prognostic factor for metastatic brain tumors but rarely occurs in gynecological cancers. A female patient who was under chemotherapy for endometrioid carcinoma was admitted to the emergency department for recent deterioration and seizures. She had confusion and left hemiparesis, along with an elevated systolic blood pressure and platelet count of 45,000 /mL. An emergent computerized tomography and subsequent magnetic resonance imaging revealed multiple hemorrhagic metastatic lesions in both hemispheres and cerebellum. Brain metastasis of endometrioid carcinoma is rare and can present with intratumoral hemorrhage, which is associated with a poor prognosis and is more likely to occur in the setting of low platelet counts. This case highlights the importance of monitoring brain metastasis in patients with endometrioid carcinoma and considering the possibility of intratumoral hemorrhage.

Keywords

endometrioid carcinoma, brain metastasis, hemorrhage, thrombocytopenia

Endometrioid Karsinomanın Çoklu Beyin Metastazında Eşzamanlı Tümöriçi Kanama: Nadir Bir Metastazın Nadir Bir Bulgusu

Abstract

Endometrioid karsinomanın beyin metastazı nadir, genellikle tekil ve kötü prognozludur. Tümör içi kanama da metastatik beyin tümörleri için kötü prognoz faktörü olmakla birlikte jinekolojik kanserlerde nadiren gerçekleşir. Endometrioid karsinoma nedeniyle kemoterapi tedavisi devam etmekte olan bir kadın hasta, bilinçte kötüleşme ve nöbet nedeniyle acil servise getirildi. Konfüzyon ve sol hemiparezi mevcut idi. Sistolik kan basıncı yüksek, trombosit sayısı ise 45.000 /mL idi. Acil bilgisayarlı tomografi ve takiben çekilen manyetik rezonans görüntülemede her iki hemisferde ve serebellumda multipl hemorajik metastatik lezyon saptandı. Endometrioid karsinomanın beyin metastazı nadirdir ve tümör içine kanama ile prezente olabilir -ki kötü prognozla ilişkilidir ve daha çok düşük trombosit sayısı durumunda ortaya çıkabilir. Bu vaka endometrioid karsinomalı hastaların beyin metastazı açısından takip edilmesinin ve böyle durumlarda tümör içi kanama olasılığının göz önüne alınmasının önemini vurgulamaktadır.

Keywords

endometrioid karsinoma, beyin metastazları, hemoraji, trombositopeni

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