A case report involving a patient with endometrial cancer (EC) who first presented with symptoms a year before diagnosis, leading to aggressive cancer progression, was recently published in Cureus.
EC ranks among the most common gynecological malignancies, with its incidence rising globally. It often presents as a low-grade tumor, and when diagnosed early, it often carries a good prognosis. However, a lack of regular medical check-ups or ignoring warning symptoms like postmenopausal bleeding can lead to late-stage presentation and poor outcomes. If left untreated, the cancer can expand from the uterus into the nearby lymph nodes, the lungs, liver, bones and brain.
The case involved a 55-year-old woman with a history of diabetes and hypertension who arrived at the emergency department reporting weakness, dizziness and progressive shortness of breath. The patient reported that she had experienced abnormal vaginal and post-coital bleeding for a year but had not followed up with her primary care provider.
Upon initial examination, the patient had severe respiratory insufficiency and required supplemental oxygen. Laboratory tests revealed elevated calcium, elevated alkaline phosphatase, high lactic acid, and significant leukocytosis; the findings together are an indicator of an underlying malignant disease.
Imaging studies showed extensive bilateral lung nodules consistent with metastases and a heterogeneous endometrial mass with cervical enlargement. Biopsies of the lung and endometrium confirmed metastatic endometrioid adenocarcinoma.
Despite initiation of supportive measures, the patient’s respiratory status rapidly declined. The patient ultimately required high-flow oxygen and opted for palliative care, declining resuscitation or intubation. She passed away shortly after hospital admission, underscoring the aggressive nature of untreated or advanced endometrial cancer.
Although EC is the most common gynecological cancer in developed countries, screening for it is not as widespread or standardized as it is for cervical cancer. This case highlights the importance of clinicians paying close attention to early symptoms, especially abnormal uterine or postmenopausal bleeding, to prevent progression to advanced disease.
“Hopefully, clinicians will continue to further encourage their patients to have proper yearly check-ups so that such diseases do not progress to this state in the future,” the authors wrote.
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