10268- MET-24 A CASE OF BRAIN METASTASIS OF UTERINE CANCER REFRACTORY TO TREATMENT DUE TO RAPID CLINICAL PROGRESSION.

Abstract The patient was a 57-year-old woman. She underwent laparotomy 14 months before her ER visit because of enlarged pelvic lymph nodes during follow-up for uterine adenomyosis. The pathological diagnosis was adenocarcinoma of adenomyosis origin, with metastasis to pelvic lymph nodes and a diagnosis of FIGO classification stage 3C1. She had been treated with six courses of TC (Paclitaxel+Carboplatin) postoperatively and was judged CR 2 months before the visit. She had visited the ER due to nausea and dizziness, and a head scan revealed a cerebellar tumor. She was admitted to the hospital on the same day for close examination and treatment. After admission, an MRI revealed a single, uniformly contrasted lesion, which was suspected of metastatic brain tumor from uterine cancer. On the 10th day of admission, we performed tumor resection and ventricular drainage. On the 15th day, nausea and dizziness improved, and the patient could eat full meals. On the 18th day, back pain and gastric discomfort due to postoperative defecation disorder appeared. FDG-PET performed on the 22nd day revealed systemic metastases, including thoracic spine and retroperitoneum. On the 33rd day, the patient developed impaired consciousness, and spinal fluid analysis showed positive atypical cells and hydrocephalus on a CT scan. After the surgery, her consciousness disorder improved, but she complicated thoracoabdominal effusion, urinary retention, and hydronephrosis, and died of multiple organ failure on the 47th day of hospitalization. Brain metastases from uterine cancer are rare, and there is little information on their clinical features, management, and prognosis. At the time of diagnosis, the patient was in an advanced state of organ failure due to metastatic lesions. When we detect brain metastasis in patients with uterine cancer, we should note that a high rate of metastasis to other organs would exist. Then, early systemic examination and therapeutic intervention are necessary.