Typical metastatic sites of recurrent EC are local pelvic recurrence, pelvic and para-aortic nodes, peritoneum, and lungs [17]. Atypical metastatic sites are extra-abdominal lymph nodes, liver, adrenals, brain, bones, and soft-tissue [17]. Vaginal bleeding is a common symptom of a local recurrence. In patients diagnosed with a distant recurrence, symptoms such as coughing, pain, lethargy, weight loss, or headaches are present in up to 70% of cases [19,20]. In one reported study, the combination of physical examination alone or in combination with symptoms resulted in detection rates of recurrence that exceeded 80% [21]. MRI Pelvis MRI may be indicated in a patient clinically suspected to have local recurrence or distant metastasis [94]. Recurrent tumor appears as a mass with high signal intensity on T2WI and enhances intensely following IV contrast administration [93]. MRI has a role in the evaluation of surgical resectability if the pelvis is the sole site of recurrence [36,95]. Evaluation and Follow-Up of Endometrial Cancer MRI Abdomen MRI may be indicated in patient clinically suspected to have local recurrence or distant metastasis [94]. Recurrent tumor appears as a mass with high signal intensity on T2WI and enhances intensely following IV contrast administration [93]. MRI may be used for assessment of metastasis of the liver, adrenals, brain, bones, and soft tissue when metastases are clinically suspected and require further investigation. CT Chest, Abdomen, and Pelvis CT may play a role in the evaluation of patients with symptoms suggestive of recurrence [71]. A study reported that 45 asymptomatic women had routine CT scans, and recurrence was diagnosed by CT in only 2 (4.4%); whereas, 37 symptomatic women had CT scans for suspicion of recurrence, and it was confirmed by CT in 17 (46%) [71].
Pretreatment Evaluation and Follow Up of Endometrial Cancer. Typical metastatic sites of recurrent EC are local pelvic recurrence, pelvic and para-aortic nodes, peritoneum, and lungs [17]. Atypical metastatic sites are extra-abdominal lymph nodes, liver, adrenals, brain, bones, and soft-tissue [17]. Vaginal bleeding is a common symptom of a local recurrence. In patients diagnosed with a distant recurrence, symptoms such as coughing, pain, lethargy, weight loss, or headaches are present in up to 70% of cases [19,20]. In one reported study, the combination of physical examination alone or in combination with symptoms resulted in detection rates of recurrence that exceeded 80% [21]. MRI Pelvis MRI may be indicated in a patient clinically suspected to have local recurrence or distant metastasis [94]. Recurrent tumor appears as a mass with high signal intensity on T2WI and enhances intensely following IV contrast administration [93]. MRI has a role in the evaluation of surgical resectability if the pelvis is the sole site of recurrence [36,95]. Evaluation and Follow-Up of Endometrial Cancer MRI Abdomen MRI may be indicated in patient clinically suspected to have local recurrence or distant metastasis [94]. Recurrent tumor appears as a mass with high signal intensity on T2WI and enhances intensely following IV contrast administration [93]. MRI may be used for assessment of metastasis of the liver, adrenals, brain, bones, and soft tissue when metastases are clinically suspected and require further investigation. CT Chest, Abdomen, and Pelvis CT may play a role in the evaluation of patients with symptoms suggestive of recurrence [71]. A study reported that 45 asymptomatic women had routine CT scans, and recurrence was diagnosed by CT in only 2 (4.4%); whereas, 37 symptomatic women had CT scans for suspicion of recurrence, and it was confirmed by CT in 17 (46%) [71].