{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:45:03Z","timestamp":1769730303265,"version":"3.49.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,10,28]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Though endometrial carcinomas are a relatively common cancer of the female genitourinary tract, they rarely metastasize. Similarly, clival metastases make up a tiny fraction of all brain metastases. To the authors\u2019 knowledge, an endometrial carcinoma clival metastasis has never been described in the literature; therefore, the authors present the following unusual case of a 69-year-old female with a history of an initially grade 2 endometrial adenocarcinoma that metastasized to her clivus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>Endometrial carcinoma has the potential to metastasize to the clivus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Endometrial carcinoma, even when initially low grade, can metastasize intracranially. Prompt diagnosis with tissue biopsy and radiation is the mainstay of treatment, although the prognosis remains poor.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24392\">https:\/\/thejns.org\/doi\/10.3171\/CASE24392<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24392","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T02:44:34Z","timestamp":1730083474000},"source":"Crossref","is-referenced-by-count":0,"title":["An unusual case of aggressive endometrial adenocarcinoma metastasis to the clivus: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Breanna L","family":"Sheldon","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, University of Arizona, Tucson, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Riordan","sequence":"additional","affiliation":[{"name":"University of Arizona School of Medicine, Tucson, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Fallahi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Banner\u2013University of Arizona Medical Center, Tucson, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shireen","family":"Samargandy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head & Neck Surgery, King Abdulaziz University, Riyadh, Al-Malaz, Saudi Arabia"},{"name":"Otolaryngology\u2013Head & Neck Surgery, University of Arizona, Tucson, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher H","family":"Le","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head & Neck Surgery, University of Arizona, Tucson, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B","family":"Avery","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, University of Arizona, Tucson, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"Acta Neurochir (Wien)","first-page":"291","article-title":"Clivus metastases: report of seven patients and literature review","volume":"151","author":"Pallini","year":"2009","unstructured":"Pallini RSabatino GDoglietto FLauretti LFernandez EMaira G. Clivus metastases: report of seven patients and literature review. Acta Neurochir (Wien). 2009;151(4):291-296."},{"issue":"7","key":"bib2","series-title":"J Laryngol Otol","first-page":"647","article-title":"Metastatic follicular thyroid carcinoma to the paranasal sinuses: a case report and review","volume":"111","author":"Altman","year":"1997","unstructured":"Altman KWMirza NPhilippe L. Metastatic follicular thyroid carcinoma to the paranasal sinuses: a case report and review. J Laryngol Otol. 1997;111(7):647-651."},{"key":"bib3","series-title":"World Neurosurg","first-page":"190","article-title":"Metastatic lesions of the clivus: a systematic review","volume":"158","author":"Jozsa","year":"2022","unstructured":"Jozsa FDas JM. Metastatic lesions of the clivus: a systematic review. World Neurosurg. 2022;158:190-204."},{"issue":"10","key":"bib4","series-title":"Anticancer Res","first-page":"5001","article-title":"Symptom outcomes of cancer patients with clival metastases treated with radiotherapy: a study of 44 patients","volume":"41","author":"Sturgis","year":"2021","unstructured":"Sturgis RMack AKim SMaier JHeath EI. Symptom outcomes of cancer patients with clival metastases treated with radiotherapy: a study of 44 patients. Anticancer Res. 2021;41(10):5001-5006."},{"key":"bib5","series-title":"ISRN Oncol","first-page":"581749","article-title":"Brain metastases from endometrial carcinoma","volume":"2012","author":"Piura","year":"2012","unstructured":"Piura EPiura B. Brain metastases from endometrial carcinoma. ISRN Oncol. 2012;2012:581749."},{"issue":"3","key":"bib6","series-title":"Cancers (Basel)","article-title":"Brain metastases from uterine cervical and endometrial cancer","volume":"13","author":"Kato","year":"2021","unstructured":"Kato MKTanase YUno MIshikawa MKato T. Brain metastases from uterine cervical and endometrial cancer. Cancers (Basel). 2021;13(3):519."},{"key":"bib7","series-title":"Pan Afr Med J","first-page":"68","article-title":"Brain metastasis of endometrial cancer: report of a case and review of literature","volume":"20","author":"Kouhen","year":"2015","unstructured":"Kouhen FAfif MEl Kabous M, et al. Brain metastasis of endometrial cancer: report of a case and review of literature. Pan Afr Med J. 2015;20:68."},{"issue":"2","key":"bib8","series-title":"Gynecol Oncol","first-page":"282","article-title":"Brain metastases in endometrial carcinoma","volume":"70","author":"Mart\u00ednez-Ma\u00f1as","year":"1998","unstructured":"Mart\u00ednez-Ma\u00f1as RMBrell MRumi\u00e0 JFerrer E. Brain metastases in endometrial carcinoma. Gynecol Oncol. 1998;70(2):282-284."},{"issue":"5","key":"bib9","series-title":"J Neurosurg","first-page":"1431","article-title":"Microsurgical anatomy and the importance of the petrosal process of the sphenoid bone in endonasal surgery","volume":"137","author":"Doniz-Gonzalez","year":"2022","unstructured":"Doniz-Gonzalez AVigo VNunez MA, et al. Microsurgical anatomy and the importance of the petrosal process of the sphenoid bone in endonasal surgery. J Neurosurg. 2022;137(5):1431-1442."},{"issue":"6","key":"bib10","series-title":"World Neurosurg","first-page":"S106","article-title":"The endoscopic endonasal approach for extradural and intradural clivus lesions","volume":"82","author":"Vellutini","year":"2014","unstructured":"Vellutini ABalsalobre LHermann DRStamm AC. The endoscopic endonasal approach for extradural and intradural clivus lesions. World Neurosurg. 2014;82(6suppl):S106-S115."},{"issue":"9","key":"bib11","series-title":"Cureus","first-page":"e5658","article-title":"Metastatic disease to clivus: biopsy or not?","volume":"11","author":"Cathel","year":"2019","unstructured":"Cathel AKhan YRBlais DMahato BMahato D. Metastatic disease to clivus: biopsy or not? Cureus. 2019;11(9):e5658."},{"issue":"7","key":"bib12","series-title":"Cancers (Basel)","first-page":"1906","article-title":"Determinants of sensitivity to radiotherapy in endometrial cancer","volume":"12","author":"Sorolla","year":"2020","unstructured":"Sorolla MAParisi ESorolla A. Determinants of sensitivity to radiotherapy in endometrial cancer. Cancers (Basel). 2020;12(7):1906."},{"issue":"6","key":"bib13","series-title":"Am J Surg Pathol","first-page":"846","article-title":"Microsatellite instability in endometrioid type endometrial adenocarcinoma is associated with poor prognostic indicators","volume":"31","author":"An","year":"2007","unstructured":"An HJKim KIKim JY, et al. Microsatellite instability in endometrioid type endometrial adenocarcinoma is associated with poor prognostic indicators. Am J Surg Pathol. 2007;31(6):846-853."},{"key":"bib14","series-title":"Annu Rev Pathol","first-page":"339","article-title":"Molecular genetics of endometrial carcinoma","volume":"14","author":"Bell","year":"2019","unstructured":"Bell DWEllenson LH. Molecular genetics of endometrial carcinoma. Annu Rev Pathol. 2019;14:339-367."},{"key":"bib15","series-title":"Ann Intern Med","first-page":"136","article-title":"Cowden\u2019s disease. A possible new symptom complex with multiple system involvement","volume":"58","author":"Lloyd","year":"1963","unstructured":"Lloyd KMIIDennis M. Cowden\u2019s disease. A possible new symptom complex with multiple system involvement. Ann Intern Med. 1963;58:136-142."},{"issue":"1","key":"bib16","series-title":"Nat Genet","first-page":"64","article-title":"Germline mutations of the PTEN gene in Cowden disease, an inherited breast and thyroid cancer syndrome","volume":"16","author":"Liaw","year":"1997","unstructured":"Liaw DMarsh DJLi J, et al. Germline mutations of the PTEN gene in Cowden disease, an inherited breast and thyroid cancer syndrome. Nat Genet. 1997;16(1):64-67."},{"issue":"4","key":"bib17","series-title":"J Med Genet","first-page":"255","article-title":"High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome","volume":"50","author":"Bubien","year":"2013","unstructured":"Bubien VBonnet FBrouste V, et al. High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome. J Med Genet. 2013;50(4):255-263."},{"issue":"21","key":"bib18","series-title":"J Natl Cancer Inst","first-page":"1607","article-title":"Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria","volume":"105","author":"Pilarski","year":"2013","unstructured":"Pilarski RBurt RKohlman WPho LShannon KMSwisher E. Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria. J Natl Cancer Inst. 2013;105(21):1607-1616."},{"issue":"4","key":"bib19","series-title":"PLoS Genet","first-page":"e1007352","article-title":"Unexpected cancer-predisposition gene variants in Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome patients without underlying germline PTEN mutations","volume":"14","author":"Yehia","year":"2018","unstructured":"Yehia LNi YSesock K, et al. Unexpected cancer-predisposition gene variants in Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome patients without underlying germline PTEN mutations. PLoS Genet. 2018;14(4):e1007352."},{"issue":"4","key":"bib1","series-title":"Acta Neurochir (Wien)","first-page":"291","article-title":"Clivus metastases: report of seven patients and literature review","volume":"151","author":"Pallini","year":"2009","unstructured":"Pallini RSabatino GDoglietto FLauretti LFernandez EMaira G. Clivus metastases: report of seven patients and literature review. Acta Neurochir (Wien). 2009;151(4):291-296."},{"issue":"7","key":"bib2","series-title":"J Laryngol Otol","first-page":"647","article-title":"Metastatic follicular thyroid carcinoma to the paranasal sinuses: a case report and review","volume":"111","author":"Altman","year":"1997","unstructured":"Altman KWMirza NPhilippe L. Metastatic follicular thyroid carcinoma to the paranasal sinuses: a case report and review. J Laryngol Otol. 1997;111(7):647-651."},{"key":"bib3","series-title":"World Neurosurg","first-page":"190","article-title":"Metastatic lesions of the clivus: a systematic review","volume":"158","author":"Jozsa","year":"2022","unstructured":"Jozsa FDas JM. Metastatic lesions of the clivus: a systematic review. World Neurosurg. 2022;158:190-204."},{"issue":"10","key":"bib4","series-title":"Anticancer Res","first-page":"5001","article-title":"Symptom outcomes of cancer patients with clival metastases treated with radiotherapy: a study of 44 patients","volume":"41","author":"Sturgis","year":"2021","unstructured":"Sturgis RMack AKim SMaier JHeath EI. Symptom outcomes of cancer patients with clival metastases treated with radiotherapy: a study of 44 patients. Anticancer Res. 2021;41(10):5001-5006."},{"key":"bib5","series-title":"ISRN Oncol","first-page":"581749","article-title":"Brain metastases from endometrial carcinoma","volume":"2012","author":"Piura","year":"2012","unstructured":"Piura EPiura B. Brain metastases from endometrial carcinoma. ISRN Oncol. 2012;2012:581749."},{"issue":"3","key":"bib6","series-title":"Cancers (Basel)","article-title":"Brain metastases from uterine cervical and endometrial cancer","volume":"13","author":"Kato","year":"2021","unstructured":"Kato MKTanase YUno MIshikawa MKato T. Brain metastases from uterine cervical and endometrial cancer. Cancers (Basel). 2021;13(3):519."},{"key":"bib7","series-title":"Pan Afr Med J","first-page":"68","article-title":"Brain metastasis of endometrial cancer: report of a case and review of literature","volume":"20","author":"Kouhen","year":"2015","unstructured":"Kouhen FAfif MEl Kabous M, et al. Brain metastasis of endometrial cancer: report of a case and review of literature. Pan Afr Med J. 2015;20:68."},{"issue":"2","key":"bib8","series-title":"Gynecol Oncol","first-page":"282","article-title":"Brain metastases in endometrial carcinoma","volume":"70","author":"Mart\u00ednez-Ma\u00f1as","year":"1998","unstructured":"Mart\u00ednez-Ma\u00f1as RMBrell MRumi\u00e0 JFerrer E. Brain metastases in endometrial carcinoma. Gynecol Oncol. 1998;70(2):282-284."},{"issue":"5","key":"bib9","series-title":"J Neurosurg","first-page":"1431","article-title":"Microsurgical anatomy and the importance of the petrosal process of the sphenoid bone in endonasal surgery","volume":"137","author":"Doniz-Gonzalez","year":"2022","unstructured":"Doniz-Gonzalez AVigo VNunez MA, et al. Microsurgical anatomy and the importance of the petrosal process of the sphenoid bone in endonasal surgery. J Neurosurg. 2022;137(5):1431-1442."},{"issue":"6","key":"bib10","series-title":"World Neurosurg","first-page":"S106","article-title":"The endoscopic endonasal approach for extradural and intradural clivus lesions","volume":"82","author":"Vellutini","year":"2014","unstructured":"Vellutini ABalsalobre LHermann DRStamm AC. The endoscopic endonasal approach for extradural and intradural clivus lesions. World Neurosurg. 2014;82(6suppl):S106-S115."},{"issue":"9","key":"bib11","series-title":"Cureus","first-page":"e5658","article-title":"Metastatic disease to clivus: biopsy or not?","volume":"11","author":"Cathel","year":"2019","unstructured":"Cathel AKhan YRBlais DMahato BMahato D. Metastatic disease to clivus: biopsy or not? Cureus. 2019;11(9):e5658."},{"issue":"7","key":"bib12","series-title":"Cancers (Basel)","first-page":"1906","article-title":"Determinants of sensitivity to radiotherapy in endometrial cancer","volume":"12","author":"Sorolla","year":"2020","unstructured":"Sorolla MAParisi ESorolla A. Determinants of sensitivity to radiotherapy in endometrial cancer. Cancers (Basel). 2020;12(7):1906."},{"issue":"6","key":"bib13","series-title":"Am J Surg Pathol","first-page":"846","article-title":"Microsatellite instability in endometrioid type endometrial adenocarcinoma is associated with poor prognostic indicators","volume":"31","author":"An","year":"2007","unstructured":"An HJKim KIKim JY, et al. Microsatellite instability in endometrioid type endometrial adenocarcinoma is associated with poor prognostic indicators. Am J Surg Pathol. 2007;31(6):846-853."},{"key":"bib14","series-title":"Annu Rev Pathol","first-page":"339","article-title":"Molecular genetics of endometrial carcinoma","volume":"14","author":"Bell","year":"2019","unstructured":"Bell DWEllenson LH. Molecular genetics of endometrial carcinoma. Annu Rev Pathol. 2019;14:339-367."},{"key":"bib15","series-title":"Ann Intern Med","first-page":"136","article-title":"Cowden\u2019s disease. A possible new symptom complex with multiple system involvement","volume":"58","author":"Lloyd","year":"1963","unstructured":"Lloyd KMIIDennis M. Cowden\u2019s disease. A possible new symptom complex with multiple system involvement. Ann Intern Med. 1963;58:136-142."},{"issue":"1","key":"bib16","series-title":"Nat Genet","first-page":"64","article-title":"Germline mutations of the PTEN gene in Cowden disease, an inherited breast and thyroid cancer syndrome","volume":"16","author":"Liaw","year":"1997","unstructured":"Liaw DMarsh DJLi J, et al. Germline mutations of the PTEN gene in Cowden disease, an inherited breast and thyroid cancer syndrome. Nat Genet. 1997;16(1):64-67."},{"issue":"4","key":"bib17","series-title":"J Med Genet","first-page":"255","article-title":"High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome","volume":"50","author":"Bubien","year":"2013","unstructured":"Bubien VBonnet FBrouste V, et al. High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome. J Med Genet. 2013;50(4):255-263."},{"issue":"21","key":"bib18","series-title":"J Natl Cancer Inst","first-page":"1607","article-title":"Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria","volume":"105","author":"Pilarski","year":"2013","unstructured":"Pilarski RBurt RKohlman WPho LShannon KMSwisher E. Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria. J Natl Cancer Inst. 2013;105(21):1607-1616."},{"issue":"4","key":"bib19","series-title":"PLoS Genet","first-page":"e1007352","article-title":"Unexpected cancer-predisposition gene variants in Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome patients without underlying germline PTEN mutations","volume":"14","author":"Yehia","year":"2018","unstructured":"Yehia LNi YSesock K, et al. Unexpected cancer-predisposition gene variants in Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome patients without underlying germline PTEN mutations. 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