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Academic Level (Author 1)

Resident

Discipline/Specialty (Author 1)

Internal Medicine

Discipline Track

Clinical Science

Abstract

Introduction: Endometrial adenocarcinoma is the most common type of uterine cancer and is divided into two types; type 1 includes 80 percent of the cases while type 2 comprises 10 to 20 percent, with latter being more aggressive. Type 2 endometrial cancer is of serous or clear cell histology and abnormal uterine bleeding is the most common clinical presentation. This case portrays an infrequent presentation of uterine cancer.

Case Presentation: A 73-year-old woman with past medical history of hypertension and diabetes mellitus type 2 presents to the emergency room with chief complaint of nausea and abdominal bloating for 2 months, associated with early satiety, decreased appetite, and weight loss of 30 pounds in over 6 months. On arrival, vitals showed T 98.2, HR 103, BP 129/72, and RR 17. Further labs demonstrated sodium 115, alkaline phosphatase 165, albumin 2.9, WBC 13.15, hemoglobin 11.7, and hematocrit 34.7. Abdominal CT scan revealed diffuse metastatic mesenteric implants. Pelvic ultrasound demonstrated multiple uterine nodules with calcifications and the presence of complex fluid within uterine cavity. Subsequently CA 125 was measured at 396 and CEA was found to be

Conclusion: Physicians rely on clinical presentation and physical exam to formulate a diagnosis. However, not every patient presents with the most common clinical symptoms. It is of utmost importance for clinicians to have a high index of suspicion, particularly in the outpatient setting and when malignancy is a potential diagnosis. The goal is to use a comprehensive clinical judgement to provide competent care to the patients and make an early diagnosis. In this manner, we hope to decrease physical, mental, and emotional burden on the patients while providing a better quality of life.

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Uterine Serous Carcinoma: a rare presentation of an uncommon type of cancer

Introduction: Endometrial adenocarcinoma is the most common type of uterine cancer and is divided into two types; type 1 includes 80 percent of the cases while type 2 comprises 10 to 20 percent, with latter being more aggressive. Type 2 endometrial cancer is of serous or clear cell histology and abnormal uterine bleeding is the most common clinical presentation. This case portrays an infrequent presentation of uterine cancer.

Case Presentation: A 73-year-old woman with past medical history of hypertension and diabetes mellitus type 2 presents to the emergency room with chief complaint of nausea and abdominal bloating for 2 months, associated with early satiety, decreased appetite, and weight loss of 30 pounds in over 6 months. On arrival, vitals showed T 98.2, HR 103, BP 129/72, and RR 17. Further labs demonstrated sodium 115, alkaline phosphatase 165, albumin 2.9, WBC 13.15, hemoglobin 11.7, and hematocrit 34.7. Abdominal CT scan revealed diffuse metastatic mesenteric implants. Pelvic ultrasound demonstrated multiple uterine nodules with calcifications and the presence of complex fluid within uterine cavity. Subsequently CA 125 was measured at 396 and CEA was found to be

Conclusion: Physicians rely on clinical presentation and physical exam to formulate a diagnosis. However, not every patient presents with the most common clinical symptoms. It is of utmost importance for clinicians to have a high index of suspicion, particularly in the outpatient setting and when malignancy is a potential diagnosis. The goal is to use a comprehensive clinical judgement to provide competent care to the patients and make an early diagnosis. In this manner, we hope to decrease physical, mental, and emotional burden on the patients while providing a better quality of life.

 

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