Pain, An Atypical Presentation of Endometrial Cancer: Case Report and Literature Review (Pages 46-53)

Oroma Nwanodi1 and Neekianund Khulpateea2

1Women’s Health Department, Myrtle Hilliard Davis Comprehensive Health Centers, – Homer G. Phillips Health Center, 2425 North Whittier Avenue, Saint Louis MO 63113, USA; 2Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn NY 11219, USA

DOI: http://dx.doi.org/10.14205/2309-4400.2013.01.02.1

Abstract: Endometrial cancer, the most common gynecologic malignancy in women in the United States typically presents with abnormal uterine bleeding. Given a case of endometrial cancer presenting as abdominal pain, we reviewed the different circumstances in which pain is the primary presenting symptom of endometrial cancer. Forty-one cases of endometrial carcinoma, were found. Patients presenting with bone pain were statistically significantly more likely to have a longer time to correct diagnosis (p<0.001), and to have metastatic disease than patients presenting with abdominal pain (p=0.001). Abdominal pain was more likely an initial presentation of endometrial cancer (p=0.003), to occur following any radiation treatment (p=0.001), and subsequent to irradiation for cervical cancer (p= 0.002), than was bone pain. Nevertheless, 21 of 32 cases (65.6%) of endometrial cancer presenting with pain for which stage is known, have advanced disease, confirming the widely held opinion that pain in endometrial cancer is indicative of advanced stage disease.

Keywords: Abdominal pain, Bone pain, Endometrial cancer, Initial presentation.