# Isolated muscle metastasis from early-stage endometrial carcinoma six years after diagnosis: A case report and literature review

## TL;DR

A rare case of endometrial cancer metastasizing to the abdominal muscle six years after diagnosis is reported, highlighting unusual patterns and treatment approaches.

## Contribution

This case report adds to the limited literature on isolated muscular metastasis in endometrial cancer and emphasizes the importance of multidisciplinary care.

## Key findings

- Muscular metastases in endometrial cancer are rare and often present diagnostic challenges.
- Surgical resection combined with adjuvant therapy can be effective for isolated muscular metastases.
- A multidisciplinary approach is essential for managing rare metastatic cases effectively.

## Abstract

Endometrial cancer is the most common gynecological malignancy, typically diagnosed at an early stage with a favorable prognosis. However, certain subtypes and molecular characteristics can predispose patients to a higher risk of recurrence and metastasis. Understanding unusual metastatic patterns, such as isolated muscular metastases, is crucial for comprehensive management and treatment strategies in endometrial cancer.

A 55-year-old woman with a previous diagnosis of grade 2 intra-mucosal endometrioid adenocarcinoma presented with a painful abdominal swelling. Imaging identified a parietal formation within the rectus abdominis muscle, initially suspected to be an endometriotic cyst. Subsequent surgical excision confirmed the presence of carcinomatous glands infiltrating the striated muscle tissue. After a complication-free surgery, the patient underwent adjuvant chemotherapy and is now being monitored for 10 months without any signs of recurrence.

The presented case underscores the rarity of muscular metastases in endometrial cancer, emphasizing the need for better understanding and awareness of unusual metastatic patterns. Detailed histological examination confirmed the secondary parietal muscular localization of the carcinoma, prompting further therapeutic management.

This case contributes to the existing literature by highlighting a unique presentation of metastatic endometrial cancer in the muscular tissue, shedding light on potential diagnostic challenges and treatment considerations. Enhanced awareness and knowledge of such atypical metastatic sites are crucial for improved patient care and outcomes.

•Metastases of endometrial carcinoma to the musculoskeletal system are infrequent.•There is limited available data on the optimal management of metastatic disease in the musculoskeletal system•Factors such as tumor size, specific histopathological and molecular features, and certain tumor subtypes are linked to poorer prognosis and increased risk of relapse.•Individualized treatment is crucial, with surgical resection of isolated metastasis and adjuvant therapy considered for certain cases with favorable performance statuses.•A multidisciplinary approach is crucial in treating rare isolated muscular metastasis in endometrial cancer effectively, ensuring comprehensive patient care.

Metastases of endometrial carcinoma to the musculoskeletal system are infrequent.

There is limited available data on the optimal management of metastatic disease in the musculoskeletal system

Factors such as tumor size, specific histopathological and molecular features, and certain tumor subtypes are linked to poorer prognosis and increased risk of relapse.

Individualized treatment is crucial, with surgical resection of isolated metastasis and adjuvant therapy considered for certain cases with favorable performance statuses.

A multidisciplinary approach is crucial in treating rare isolated muscular metastasis in endometrial cancer effectively, ensuring comprehensive patient care.