COEXISTING ENDOMETRIAL CARCINOMA WITH RENAL ANGIOMYOLIPOMA

Abstract

38 yr old Mrs. Saraswathy presented with           complaints of profuse bleeding pv during periods for 2 months not associated with dysmenorrhea. There was no history suggestive of any infection, local pathology, IUCD insertion or any other relevant history. She is a P2L2, both full term           normal vaginal delivery, sterilized and her last child birth was 18 yrs back. On examination, there was a retroverted, bulky uterus, mobile, fornices were free and cervix was healthy. Her blood investigations were normal. Fractional curettage report showed a moderately differentiated endometrial                      adenocarcinoma grade 2. CT abdomen showed diffuse                endometrial thickening with invasion of inner myometrium in the posterior wall of uterus and invasion of upper cervix,  suggestive of endometrial carcinoma. No evidence of tumour spread to the serosa or parametrium. There was no distant metastasis or ascites. There was a 5x4 cm mass with fat and soft tissue areas in the anterior aspect of lower pole of left kidney- Angiomyolipoma (possibility of malignancy cannot be ruled out). Staging laparotomy proceeded to radical                  hysterectomy with lymph node sampling and left nephrectomy was done. Histopathology showed possibility of                    Angiomyolipoma of the kidney with co existing Renal cell carcinoma. Suggested immunohistochemistry for                    confirmation. Moderately differentiated endometrial                 adenocarcinoma grade 2 with more than 50 myometrial           invasion extending upto the lower uterine segment and upper cervix. Nodes were negative. Immunohistochemistry findings confirmed it to be Angiomyolipoma of the kidney only. Patient is under radiotherapy. This case is being presented for                 its rarity..