# Solitary mandibular recurrence of uterine endometrial carcinoma successfully treated with chemotherapy alone: A case report

## TL;DR

A rare case of uterine cancer recurring in the jaw was successfully treated with chemotherapy alone, avoiding surgery or radiation.

## Contribution

This case report presents a rare instance of mandibular recurrence treated with lenvatinib and pembrolizumab, achieving complete response.

## Key findings

- A 56-year-old woman with uterine clear cell carcinoma had a rare mandibular recurrence.
- Treatment with lenvatinib and pembrolizumab led to complete tumor regression without surgery or radiotherapy.
- Mandibular pain and trismus may signal metastasis in gynecologic cancer patients.

## Abstract

•Solitary mandibular metastasis from uterine clear cell carcinoma is extremely rare.•We presented lenvatinib and pembrolizumab therapy achieved complete response without surgery or radiotherapy.•Mandibular pain and trismus may indicate metastasis in gynecologic cancer patients.

Solitary mandibular metastasis from uterine clear cell carcinoma is extremely rare.

We presented lenvatinib and pembrolizumab therapy achieved complete response without surgery or radiotherapy.

Mandibular pain and trismus may indicate metastasis in gynecologic cancer patients.

Recurrence of endometrial carcinoma typically occurs in the pelvic region, with the lungs and lymph nodes being common sites for distant metastasis. However, recurrence involving the head and neck region is exceedingly rare.

We report a case of solitary mandibular recurrence of endometrial carcinoma successfully treated with lenvatinib and pembrolizumab. A 56-year-old woman was diagnosed with stage II clear cell carcinoma of the uterus. She underwent total abdominal hysterectomy, bilateral adnexectomy, partial omentectomy, appendectomy, pelvic and para-aortic lymphadenectomy. Postoperative adjuvant chemotherapy with six cycles of paclitaxel and carboplatin was administered, followed by observation. Two months after the completing of treatment, the patient developed trismus and pain in the left mandible. Imaging studies revealed a 4 cm mass in the left mandible. Needle biopsy confirmed a solitary recurrence of endometrial carcinoma. After the administration of pembrolizumab and lenvatinib therapy, the tumor was no longer detectable, which has been maintained.

Mandibular metastasis from endometrial carcinoma is extremely rare and may mimic primary jaw tumors. Treatment options include surgical resection, radiotherapy, and systemic therapy. A comprehensive evaluation of the primary tumor status, presence of other metastases, and the patient’s functional condition is essential for determining the optimal therapeutic strategy.