Isolated Splenic Metastasis from Endometrial Carcinoma: A Rare Case Report from a Resource-Limited Setting

Isolated splenic metastasis from endometrial carcinoma is an exceptionally rare clinical entity that typically occurs years after primary treatment. Most cases are identified incidentally during surveillance imaging, and diagnosis may present significant clinical and pathological challenges, particularly in resource-limited settings. We report the case of a 50-year-old Sudanese woman with high-grade serous endometrial carcinoma who presented two years after primary treatment with left upper quadrant pain and low-grade fever. Radiological evaluation using ultrasonography, contrast-enhanced computed tomography, and magnetic resonance imaging demonstrated a solitary splenic lesion without evidence of additional metastatic disease. Following multidisciplinary evaluation, the patient underwent diagnostic laparoscopy and splenectomy. Intraoperative assessment revealed no peritoneal, hepatic, nodal, or pelvic metastatic involvement. Histopathological examination confirmed metastatic poorly differentiated adenocarcinoma consistent with endometrial origin. The postoperative course was uneventful, and the patient remained clinically stable during early follow-up. This case highlights the diagnostic and therapeutic challenges associated with isolated splenic metastasis from endometrial carcinoma and emphasises the importance of multidisciplinary management in resource-limited settings.