PMC9897710_01
Retroauricolar swelling suspected for secondarism (black arrow)
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FIG1
During an outpatient visit in March 2019, an accurate physical examination revealed a right retroauricular swelling with hard consistency on palpation, fixed on superficial and deep planes, intact skin, retronuchal, and tempo-parietal spontaneous pain exacerbated by acupressure (Figure 1).
Biopsy diagnostic for metastasis from endometroid adenocarcinoma
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FIG2
Histological examination was compatible with metastasis of previous endometrioid adenocarcinoma (Figure 2).
Lung metastases from endometrioid adenocarcinoma (black arrows)
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FIG3
A restaging total-body computer tomography (CT) described osteolytic alteration of the right mastoid and part of ipsilateral occiput related to heteroplastic tissue of about 5 x 5 cm with calcifications, necrotic-colliquative areas and dyshomogeneous impregnation after contrast, laterally extending and infiltrating retro and supra auricular subcutaneous soft tissues, in contiguity with homolateral sigmoid sinus which appears to be thrombosed, indissociable from the posterior profile of the superior projection of the parotid gland; multiple bilateral pulmonary nodular lesions of 2 cm in greatest diameter (Figure 3), numerous liver metastases (Figure 4), the greatest of about 5 x 4 cm; osteolytic areas in left iliac wing, right ischiopubic branch, and right scapula.
Liver metastases from endometrioid adenocarcinoma (black arrows)
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FIG4
A restaging total-body computer tomography (CT) described osteolytic alteration of the right mastoid and part of ipsilateral occiput related to heteroplastic tissue of about 5 x 5 cm with calcifications, necrotic-colliquative areas and dyshomogeneous impregnation after contrast, laterally extending and infiltrating retro and supra auricular subcutaneous soft tissues, in contiguity with homolateral sigmoid sinus which appears to be thrombosed, indissociable from the posterior profile of the superior projection of the parotid gland; multiple bilateral pulmonary nodular lesions of 2 cm in greatest diameter (Figure 3), numerous liver metastases (Figure 4), the greatest of about 5 x 4 cm; osteolytic areas in left iliac wing, right ischiopubic branch, and right scapula.
Clinical course of the disease
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FIG5
AUC 2 plus weekly paclitaxel with schedule g1-g8-g15 q28 (Figure 5). After three months, retroauricular swelling was reduced, as well as the pain, with stable disease on liver and lung assessment.