Abstract
In the absence of significant extracranial disease, patients with solitary brain metastases
have shown benefit with resection. Brain lesions due to endometrial cancer are uncommon,
and the only described skull base involvement is limited to the pituitary gland. We
report the case of a 60-year-old female with endometrial cancer who presented with
weeks of right cheek pain and numbness that was accompanied by headaches. We describe
the magnetic resonance imaging (MRI) findings and surgical resection of a solitary
endometrial metastasis involving the infratemporal fossa, middle fossa, cavernous
sinus, trigeminal nerve, and nasal sinuses. Due to extensive nasal and lateral involvement,
a combined open and endoscopic approach was planned. The patient was discharged home
without complication. She underwent adjuvant radiotherapy. Despite its suspected indolent
course, intracranial endometrial adenocarcinoma metastases are gaining higher prevalence.
This case report documents the first direct neural spread of an endometrial primary,
and highlights the potential for extra-axial sites of metastasis.
Keywords
skull base metastasis - endometrial carcinoma - endoscopic endonasal approach - neuro-oncology
- anatomic pathology - middle fossa lesion
