Serous Endometrial Case

Endometrial cancer usually spreads first to lymph nodes deep in the pelvis, but a new case report describes serous disease that showed up in the groin instead. (cureus.com) The report, published by Cureus in 2026, followed a 42-year-old woman with serous endometrial carcinoma and metastatic right inguinal lymph nodes measuring up to 21 millimeters on imaging. The authors said they did not find other distant metastases at diagnosis. (cureus.com) Doctors confirmed the uterine tumor with an endometrial aspiration biopsy and used immunohistochemical testing, a lab method that tags tumor proteins to help identify the cancer type. They treated her with neoadjuvant chemotherapy, meaning drugs given before an operation to shrink or control disease before surgery. (cureus.com) That sequence differs from the usual starting point for many uterine cancers, where surgery comes first if the disease looks operable. National Comprehensive Cancer Network patient guidance says treatment for uterine cancer, when possible, involves surgery to remove the uterus and cervix. (nccn.org) Serous endometrial carcinoma is not the most common uterine cancer subtype, but it causes a disproportionate share of deaths. A review in *Gynecologic Oncology* said serous tumors make up about 10% of diagnosed endometrial cancers and account for roughly 40% of endometrial cancer-related deaths. (gynecologiconcology-online.net) The groin finding stands out because inguinal nodes sit outside the lymphatic route doctors usually watch first in endometrial cancer. The Cureus authors said typical spread involves pelvic and para-aortic lymph nodes and the peritoneal surfaces, while inguinal node metastasis is extremely uncommon. (cureus.com) Rare does not mean unheard of. A 2021 PubMed-indexed case report described a 72-year-old woman with grade 3 serous endometrial cancer who developed bilateral inguinal lymph node metastases 18 months after surgery, showing that groin spread has been documented before but remains unusual. (pubmed.ncbi.nlm.nih.gov) The treatment choice also fits a broader shift toward more tailored systemic therapy in advanced or high-risk uterine cancer. National Comprehensive Cancer Network updates in 2025 highlighted changes tied to the FIGO 2023 staging system and newer systemic therapy recommendations for endometrial cancer management. (education.nccn.org) In this case, the authors used chemotherapy first and then proceeded to radical cytoreductive surgery, a cancer operation aimed at removing as much visible tumor as possible. The report frames the case as an example of multimodal care for a high-risk uterine cancer presenting in an unexpected place. (cureus.com) For clinicians, the practical point is simple: a groin node can be the clue that leads back to an aggressive uterine cancer, even when the spread pattern is atypical. For patients, the case shows how doctors may combine biopsy, chemotherapy, and surgery when serous endometrial cancer does not follow the usual map. (cureus.com))