Discovery of an endometrioid cancer lymph node metastasis without primary tumor in a context of Lynch syndrome - 14/02/21
, Johan Pacelli a, Marie-Aude Lefrère Belda d, Henri Azaïs a, Anne-Sophie Bats a, b, eBienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | Immunohistochemistry expression profile is fundamental in cancer of unknown primary origin. |
• | Pelvic ultrasound and endometrial biopsy must be performed before risk-reducing surgery in Lynch syndrome. |
• | Lymph node assessment before prophylactic surgery in Lynch syndrome should be considered. |
Abstract |
Introduction |
Lynch syndrome is a hereditary predisposition to cancers, including colo-rectal and endometrial cancers in women. Prophylactic surgery including hysterectomy and bilateral salpingo-oophorectomy is recommended once the parental project is completed in case of identified mutation.
Case presentation |
We describe the case of a 50-year-old patient with Lynch syndrome and identified MSH6 mutation who underwent a prophylactic hysterectomy with bilateral salpingo-oophorectomy. A left large broad ligament lesion suggestive of a fibroma was intraoperatively discovered and removed. Pathological examination and immunohistochemical study showed a lymph node macro-metastasis of an endometrioid adenocarcinoma, without primary tumor.
Discussion/conclusion |
Lymph node metastasis can occur before endometrial cancer but the link with Lynch syndrome remains to be proved. Lymph node assessment by imaging before prophylactic surgery in Lynch syndrome could be considered.
Le texte complet de cet article est disponible en PDF.Keywords : Lynch syndrome, Prophylactic surgery, Hysterectomy, Pelvic nodes
Plan
Vol 50 - N° 3
Article 102060- mars 2021 Retour au numéro
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