Common cancer, puzzling presentation: A report of endometrial cancer presenting as an obstructive duodenal mass

The risk of extrauterine spread in endometrial cancer depends on the histologic type and grade. Metastatic endometrial cancer typically follows a predictable pattern of spread, favoring the lymphatic route. We report an unusual case of a patient with International Federation of Gynecology and Obstetrics (FIGO) grade 2 endometrioid endometrial cancer who presented with an obstructive duodenal mass with no other preoperative evidence of disease. Available diagnostic data suggested a possible second primary cancer. Upon entering the abdomen, it became apparent that the duodenal mass was a metastatic focus. The final pathology revealed a high-grade serous component. Underestimation of endometrial biopsy, failure of diagnostic imaging, and the nonspecificity of fine needle aspiration led to diagnostic difficulty. Staging laparoscopy may be useful in such cases.