Palliative segmental duodenectomy for bleeding, erosive endometrial cancer

Abstract

Background Endometrial cancer is the fourth most common malignancy among women. Metastases typically involve the lungs, peritoneal surfaces of the abdominal cavity, and lymph nodes outside the pelvis. Case We report an unusually difficult complication of metastatic endometrial cancer occurring in a 57 year-old woman with paraaortic nodal recurrence: refractory occult gastrointestinal bleeding. Repeated upper endoscopic evaluation revealed an extrinsic mass eroding into the third portion of the duodenum. Segmental duodenal resection was performed, and the GI tract was reconstructed with a side-to-side duodenojejunostomy. The postoperative course was uneventful, and the patient experienced durable relief from continued bleeding and impending obstruction. Conclusion We review the role of palliative surgery for bleeding complications of advanced cancer and the alternatives for treating invasive extrinsic lesions of the duodenum.