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Cannonball metastases from endometrial cancer

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Shortness of breath

Patient Data

Age: 75 years
Gender: Female

Multiple rounded mass lesions in both lung fields, consistent with metastatic deposits.

Widening of the superior mediastinum is also demonstrated suggesting possible mediastinal lymphadenopathy.

Superimposed atelectasis is noted in the right mid zone region.

Numerous pulmonary nodules and masses scatttered throughout all the lobes.

No pleural or pericardial effusion. No axillary, hilar or mediastinal lymphadenopathy. No evidence of mass causing tracheal deviation. No breast lesion or axillary lymphadenopathy.

The kidneys are slightly atrophic and contain multiple hypodense cysts, too small to characterize. No solid lesion seen. Uncomplicated sigmoid diverticulosis. The uterus is not seen, consistent with prior hysterectomy. Fatty atrophy of the pancreas. The remainder of the abdominal and pelvic viscera are unremarkable. No abdominal or inguinal lymphadenopathy. No free intraperitoneal fluid or gas.

S-shaped lumbar scoliosis. 4 mm anterolisthesis of L4 on L5. Previous L4 laminectomy. No suspicious bony lesion.

Conclusion

  • Numerous bilateral pulmonary 'cannonball' metastases. No primary seen.
  • No evidence of metastatic disease elsewhere.

Case Discussion

Previous hysterectomy was performed for endometrial cancer. Lung biopsy confirmed endometrial metastases. Endometrial cancer is a known cause of cannonball metastases, however, more common causes are:

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