Rare case of invasive lobular breast cancer metastasis to the endometrium

Metastases to the female genital tract from extra-genital primary cancers are uncommon and usually occur during widespread metastatic disease. Breast cancers are the most frequent primaries, predominantly the lobular type. Here, we report a case of a 55-year-old woman with breast cancer endometrial metastasis who presented with postmenopausal vaginal bleeding. We highlight the importance of endometrial sampling to confirm the diagnosis and distinguish primary from metastatic cancer of the endometrium since the treatment and prognosis of these conditions are entirely different.

Vaginal bleeding during menopause hormone therapy. Is it always endometrial cancer? How to choose the appropriate tactics for examination and management of patients?

The article provides an overview of the possible causes of bleeding from the genital tract in peri- and postmenopausal women. The correct approach to patients with abnormal uterine bleeding during menopausal hormone therapy is described. A modern analysis of data on the diagnosis and treatment of postmenopausal vaginal bleeding against the background of menopausal hormone therapy was carried out. The modern possibilities of endometrial diagnostics and treatment are shown.

Parathyroid hormone independent hypercalcemia in the setting of non metastatic leiomyosarcoma

Background: We present an atypical case involving humoral hypercalcemia of malignancy arising in a patient with non-metastatic leiomyosarcoma. Cases of hypercalcemia of unknown source should prompt suspicion for rare tumors. Case: A 56 year old woman requires hospitalization for hypercalcemia with low intact parathyroid hormone where renal ultrasound incidentally reports a uterine fibroid. Previous workup for a 9 month history of postmenopausal vaginal bleeding was found to be negative. Bone scan, computed tomography chest, mammogram, ultrasound of thyroid were negative. Dilatation and curettage revealed leiomyosarcoma. Hysterectomy causes complete resolution of her hypercalcemia. Conclusions: Parathyroid hormone independent hypercalcemia in the setting of uterine mass should raise suspicion for paraneoplastic syndrome with biochemical and surgical workup to exclude leiomyosarcoma.