Valerio Gallotta1, Marco D'Indinosante2, Camilla Nero2, Maria Teresa Giudice2, Carmine Conte2, Claudio Lodoli3, Gian Franco Zannoni4, Anna Fagotti5, Giovanni Scambia2. 1. Department of Women's and Children's Health, "Agostino Gemelli" Foundation University Hospital, Rome, Italy. Electronic address: gallottav@gmail.com. 2. Department of Women's and Children's Health, Catholic University of the Sacred Heart, Rome, Italy. 3. General Surgery Unit, Catholic University of the Sacred Heart, Rome, Italy. 4. Department of Pathology, Catholic University of the Sacred Heart, Rome, Italy. 5. Department of Women's and Children's Health, "Agostino Gemelli" Foundation University Hospital, Rome, Italy.
Abstract
STUDY OBJECTIVE: To demonstrate management of a rare case of an isolated intraparenchymal splenic metastasis of endometrial cancer with robotic-assisted surgery. DESIGN: Case report (Canadian Task Force Classification III). SETTING: A 55-year-old patient with a history of endometrial cancer was found to have a splenic lesion on a follow-up examination. She underwent surgical staging, involving total hysterectomy, bilateral salpingo-oopherectomy, pelvic lymphadenectomy, and peritoneal washing, in 2014, and the final pathological findings showed an endometrioid endometrial adenocarcinoma, International Federation of Gynecology and Obstetrics stage IB G2. Multidisciplinary counseling was provided, and the patient opted for strict medical surveillance. At 20 months after the primary treatment, the patient experienced a vaginal cuff recurrence and refused radiation therapy. She instead underwent robotic surgery, followed by 6 cycles of carboplatin 6 AUC and paclitaxel 175 mg/m2. Seventeen months later, a positron emission tomography/computed tomography scan revealed a 3-cm intraparenchymal lesion of the spleen, and robotic splenectomy was scheduled. The Institutional Review Board approved this study. INTERVENTION: The operative time was 90 minutes, and blood loss was <50 mL. The operation was performed successfully, with no intraoperative and postoperative complications. Histopathological analysis showed a 3-cm intraparenchymal splenic lesion. The patient was discharged on day +2, and 46 days later started adjuvant chemotherapy based on carboplatin 6 AUC and doxorubicin (Caelyx) 30 mg/m2. At a 2-month follow-up, the patient was disease-free and in good general condition. CONCLUSION: This case demonstrates the successful robotic management of recurrent endometrial cancer.
STUDY OBJECTIVE: To demonstrate management of a rare case of an isolated intraparenchymal splenic metastasis of endometrial cancer with robotic-assisted surgery. DESIGN: Case report (Canadian Task Force Classification III). SETTING: A 55-year-old patient with a history of endometrial cancer was found to have a splenic lesion on a follow-up examination. She underwent surgical staging, involving total hysterectomy, bilateral salpingo-oopherectomy, pelvic lymphadenectomy, and peritoneal washing, in 2014, and the final pathological findings showed an endometrioid endometrial adenocarcinoma, International Federation of Gynecology and Obstetrics stage IB G2. Multidisciplinary counseling was provided, and the patient opted for strict medical surveillance. At 20 months after the primary treatment, the patient experienced a vaginal cuff recurrence and refused radiation therapy. She instead underwent robotic surgery, followed by 6 cycles of carboplatin 6 AUC and paclitaxel 175 mg/m2. Seventeen months later, a positron emission tomography/computed tomography scan revealed a 3-cm intraparenchymal lesion of the spleen, and robotic splenectomy was scheduled. The Institutional Review Board approved this study. INTERVENTION: The operative time was 90 minutes, and blood loss was <50 mL. The operation was performed successfully, with no intraoperative and postoperative complications. Histopathological analysis showed a 3-cm intraparenchymal splenic lesion. The patient was discharged on day +2, and 46 days later started adjuvant chemotherapy based on carboplatin 6 AUC and doxorubicin (Caelyx) 30 mg/m2. At a 2-month follow-up, the patient was disease-free and in good general condition. CONCLUSION: This case demonstrates the successful robotic management of recurrent endometrial cancer.
Authors: Marko M Stojanovic; Vesna Brzački; Jelena D Zivadinovic; Nebojsa S Ignjatovic; Marko D Gmijovic; Miodrag N Djordjevic; Ilija Golubovic; Nada G Nikolić; Novica Z Bojanic; Miroslav P Stojanovic Journal: Medicina (Kaunas) Date: 2022-04-26 Impact factor: 2.948