Endocrine Abstracts

Background: Although most solid primary tumors can metastasize to the adrenal glands, lung cancer is the most common, followed by renal cell carcinoma, melanoma and colorectal cancer. However endometrial cancer metastasis to adrenal gland is very rare. There are only a few case in literature. Endometrial cancer is the most common gynecological malignancy. In this case, we present a case of adrenal gland metastasis of endometrial cancer.

Case presentation: 83-year-old female, presented with a 3 months history of nausea. She doesn’t have any comorbidities other than endometrial carcinoma. In 2022, she was diagnosed with endometrium carcinoma, stage IIB, endometrioid type. She hadn’t received chemotherapy and radiotherapy. In computerized thomography (CT) of December 2021, there was no adrenal gland mass. In the past 3 months she had lost 4 kilograms. So a new abdomen CT has performed. On the left adrenal gland 68 mm mass has spotted. The patient was normotensive, she hadn’t have a moon face, buffalo hump, thinning of skin. The preoperative laboratory findings are as follows: Dehydroepiandrosterone sulfate 13.6 μg/dl, total testosteron <12.98 ng/dl, aldosteron/renin activity 0.4, 1 mg dexamethasone suppression test was normal. On May 2023 left adrenalectomy, distal pancreatectomy, splenectomy had performed. Pathology result is high grade endometrial adenocarcinoma metastasis. After operation, she has been discharged from the hospital.

Conclusion: Endometrial carcinoma metastasis to adrenal gland is a rare occurrence, and its diagnosis requires suspicion, especially in patients with new symptoms. Definitive diagnosis is achieved through imaging and biopsy. The management of adrenal gland metastasis in endometrial carcinoma depends on the extent of disease and the patients’ overall condition. In isolated cases, surgical resection can be considered. This case highlights the importance of considering distant metastases, including adrenal gland involvement, in patients with a history of endometrial carcinoma.