Clear cell carcinoma (CCC) of the uterus is a rare subtype of endometrial cancer, accounting for about 5% of cases and associated with poor prognosis. Limited data on CCC makes treatment challenging, with most guidelines based on retrospective studies. This case illustrates the use of radiation therapy for durable local control in a patient with oligometastatic uterine CCC. A 68-year-old woman was diagnosed with stage IA uterine CCC in March 2020. Following surgery, adjuvant chemotherapy, and brachytherapy, she developed an abdominal wall oligometastasis. Despite initial systemic treatment, her disease progressed with the appearance of a new lung nodule. She received definitive radiation therapy for the lung and abdominal wall oligometastases with complete resolution of both lesions on PET-CT scan. However, the patient developed systemic disease progression at distant sites 18 months later, for which she received further systemic therapy. Despite further disease progression, both irradiated sites (abdominal lesion and lung nodule) remained in complete remission with durable local control maintained for 25 months of follow-up. Radiation therapy provided effective and durable local control in this case of oligometastatic uterine CCC. This suggests that definitive radiotherapy may be beneficial for managing managing oligometastatic CCC, though more research is needed to optimize treatment strategies. To our knowledge, there are no published reports describing the use of definitive radiotherapy for treating abdominal wall oligometastases from uterine CCC. This case is unique in demonstrating a durable complete response of this oligometastatic lesion following definitive external beam radiation (EBRT).
Mobayed et al. (2026) studied this question.