A 54-year-old perimenopausal
woman complained of abnormal uterine bleedings and lower abdominal pain for 6
months. Personal antecedents were smoking, hypertension, chronic obstruction
pulmonary disease, obstructive sleep apnea, obesity (BMI 42.7 kg/m2) and
nulliparity.
The first exploration showed high
tumor markers (Ca125 890 UI/ml, Ca19.9 960 UI/ml) and an enlarged uterus with
thickened endometrium, but the gynecological examination was unreliable.A
diagnostic hysteroscopy showed an abnormal growth on the entire endometrial
cavity with atypical vascularization.
Biopsy
was consistent with low-grade endometrial adenocarcinoma.The pelvic magnetic
resonance (MR) showed a large uterus, occupied by an endometrial carcinoma 4 mm
close to the uterine serosa. There was an invasion to the cervix stromal, a
left 20 cm heterogeneous and a hypovascular multiloculated adnexal mass adhered
to mesosigma. No ascites or carcinomatosis were found.
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