Axillary metastasis in non-specific molecular profile of endometrial carcinoma: a case report and literature review.

BACKGROUND: Axillary metastasis in endometrial cancer is a rare entity. We present a case of axillary metastasis from high-grade endometrial carcinoma with a non-specific molecular protein classification. CASE PRESENTATION: A 63-year-old woman with postmenopausal bleeding underwent a laparotomy for complete surgical staging and continued with adjuvant chemoradiation for stage IV high-grade endometrial carcinoma. Molecular profiling was performed and classified as non-specific molecular profile (NSMP). After completion of primary treatment, 10 months later, the patient developed a left axillary lump, which was confirmed on tumor resection specimen to be metastatic endometrial carcinoma. The patient then received another six cycles of chemotherapy and remains under surveillance with no evidence of disease after 2 years. DISCUSSION: There are several pathways for metastasis to axillary nodes in endometrial cancer. The most probable is hematogenous spread. The NSMP group has an intermediate prognosis, with a tendency toward distant metastasis. Treatment options can vary from surgery with chemo- and/or radiotherapy to systemic therapy alone. CONCLUSION: Axillary metastasis in endometrial carcinoma is a rare finding, either as a primary event or in a recurrent setting. The NSMP molecular profile may be associated with distant metastasis, although the mechanism remains unknown. We suggest aggressive locoregional management, including surgery with chemo- and/or radiation therapy, which may be considered in similar cases with favorable outcomes.