Work

Cannonball Metastases of the Lung: An Unusual Initial Manifestation of Endometrial Carcinoma

Year: 2026

Type: article

Abstract: Endometrial carcinoma is the most common gynecologic malignancy in developed countries and is typically diagnosed at an early stage, with distant metastases uncommon at presentation. Pulmonary involvement occurs in less than 5% of cases and usually manifests as small nodules or interstitial disease; the appearance of multiple, large, round 'cannonball' metastases is exceptionally rare. We report the case of a 60-year-old woman who presented with cough and dyspnea. Imaging revealed numerous bilateral pulmonary 'cannonball' nodules, mediastinal lymphadenopathy, hepatic lesions, and an enlarged uterus. Endometrial biopsy confirmed endometrioid adenocarcinoma, staged as FIGO IV-B. The patient underwent chemotherapy with carboplatin and paclitaxel, resulting in significant regression of pulmonary and hepatic metastases and symptomatic improvement, followed by maintenance therapy with anastrozole that achieved stable disease on surveillance. This case highlights the importance of recognising cannonball pulmonary metastases as a potential, albeit rare, initial presentation of endometrial carcinoma, thereby guiding timely diagnosis and treatment.

Source: Respirology Case Reports

DOI: 10.1002/rcr2.70455

Authors: Midila Bapineni, Shivendra Tangutoori, Naga Vamsi Krishna Machineni, Kamlesh Sajnani, Maneesh Gaddam

Institution: Appalachian Regional Healthcare

Language: English

Topic: Metastasis and carcinoma case studies

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,130