Posterior Pelvic Exenteration for Atypical Recurrence after Surgically Treated and Irradiated Endometrial Cancer

Endometrial carcinoma is the fifth most common malignancy in women worldwide and the most common gynaecologic cancer in developed countries, being associated with increased fat consumption, obesity and exposure to unopposed estrogens (1,2,3). Endometrial cancer is usually diagnosed in an early stage of the disease
up to 75% of cases are diagnosed in stage I of the disease and are associated with good long term prognosis.
Unfortunately, it is estimated that in time 13% of cases diagnosed with endometrial cancer will develop recurrence, in these cases the mortality rate being up to 25% (4,5). Once the recurrent disease is diagnosed, the main therapeutic options include chemotherapy for distant or widely metastatic recurrence, radiotherapy for small, isolated pelvic recurrences especially if the patient had not been submitted to radiation therapy previously and resection for cases presenting localized centro-pelvic recurrence (6-8). However, most patients experiencing pelvic recurrence within the first three years after the initial diagnosis are diagnosed with vaginal vault relapse, in these cases total colpectomy or even pelvic exenteration being required (7,9,10).