Duodenal metastasis from endometrial cancer: A rare metastatic site, a case report and literature review.

Duodenal metastasis from endometrial cancer is exceedingly rare, with only seven cases reported in the literature. While endometrial cancer typically spreads to lymph nodes, lungs, and the peritoneum, gastrointestinal involvement, particularly in the duodenum, is an uncommon and diagnostically challenging occurrence. We report the case of a 49-year-old woman initially treated for a stage IIIC2, grade 2 endometrioid adenocarcinoma via total hysterectomy, lymphadenectomy, and adjuvant radiochemotherapy. After 1 year of complete remission, she presented with epigastric pain and hematuria. Imaging revealed circumferential thickening of the third portion of the duodenum, complicated by a rare duodenopyelic fistula and right renal obstruction. Endoscopic biopsy confirmed a poorly differentiated carcinoma of endometrial origin. Palliative management involved duodenal stenting, ureteral JJ stent placement, and systemic chemotherapy. This case highlights that duodenal metastasis from endometrial adenocarcinoma is often diagnosed late and carries a poor prognosis, necessitating a multimodal palliative approach aimed at symptom control.