Page 92 - GTM-3-1

Global Translational Medicine

CASE REPORT
You’re a pain in my side! Abscess and

microperforation as a complication of therapy
from early-stage endometrial cancer: A

case report

Jennifer McCall*, Jena Hall, and Elena Park
Department of Obstetrics and Gynecology, Queen’s University, Kingston, Ontario, Canada

Abstract
This paper reports on a 55-year-old woman presenting with left lower quadrant
and groin pain that posed a significant diagnostic challenge. She had a history of
obesity and stage 1B endometrial carcinoma treated with surgery and radiation
1-year prior. Despite several unsuccessful biopsy attempts and unclear imaging
findings, she was ultimately diagnosed with a pelvic sidewall abscess secondary to
a bowel microperforation, a rare late complication of radiation related to adhesions,
weakened bowel, and peristalsis. Her condition was successfully treated with
drainage and antibiotics. It is widely known that patients with endometrial cancer
and comorbid obesity often experience diagnostic delay, weight stigma, and other
barriers and thus deserve careful attention and continued advocacy.

Keywords: Endometrial cancer; Obesity; Weight stigma; Radiation; Case report
*Corresponding author:
Jennifer McCall
(jmccall@qmed.ca)
Citation: McCall J, Hall J, 1. Background
Park E. You’re a pain in my side! Uterine cancer is the fourth most common cancer among females in Canada and sixth
Abscess and microperforation as
1,2
a complication of therapy from most common cancer in the world. Both the incidence and the mortality rates of
early-stage endometrial cancer: uterine cancer are increasing. Obesity is the main underlying cause for the increasing
1,3
A case report. Global Transl Med. incidence globally. Risk factors for endometrial cancer include advanced age, nulliparity,
3
2024;3(1):2114.
https://doi.org/10.36922/gtm.2114 obesity, sedentary lifestyle, early menarche, anovulatory cycles, late menopause,
unopposed systemic estrogen, tamoxifen use, diabetes, pelvic radiation, hypertension,
Received: October 26, 2023
Accepted: January 30, 2024 family history, and genetic conditions. 2,4,5 The International Federation of Gynecology
Published Online: March 19, 2024 and Obstetrics (FIGO) staging system is the most widely used in the world, with an
6
Copyright: © 2024 Author(s). update published in 2023. Stage I is confined to the uterine corpus and ovary, further
This is an Open-Access article subdivided into stage IA characterized by invasion into less than half the myometrium
distributed under the terms of the for non-aggressive histological types and stage IB for invasion into more than half the
Creative Commons Attribution
6
License, permitting distribution, myometrium for non-aggressive histological types. The mainstay of management is
and reproduction in any medium, cytoreductive surgery, with minimally invasive surgery being a safe alternative with
provided the original work is better perioperative and post-operative outcomes and comparable oncologic outcomes
properly cited.
3,7
8
in affected individuals, including obese patients. However, one study found that
Publisher’s Note: AccScience conversions occur in 31% of laparoscopic hysterectomies for endometrial cancer in
Publishing remains neutral with 9
regard to jurisdictional claims in patients with obesity. Many patients undergoing major gynecologic oncology surgery,
published maps and institutional including open hysterectomy, will experience early complications, including 35% with
affiliations.
Volume 3 Issue 1 (2024) 1 https://doi.org/10.36922/gtm.2114