Chylaskos as a presentation of serous papillary adenocarcinoma of the endometrium: a case report

A 77-year-old female was presented to the emergency department with intense anorexia, weight loss despite progressive abdominal distension, and dyspnea. Abdomen imaging studies revealed moderate-volume ascites and a hepatic space-occupying lesion. Diagnostic paracentesis allowed the drainage of a chylous effusion and cytology analysis identified adenocarcinoma cells. Hepatic metastasis of papillary serous adenocarcinoma of the endometrium was confirmed after tomography-guided biopsy. Endometrial carcinoma is the most common malignant gynecological neoplasm in developed countries and is often classified in type I with endometrioid histology (estrogen-dependent) and non endometrioid type II (non-estrogen-dependent). Chylous ascites or chylaskos is a rare presentation on hospital admission. Several etiologies have been described. In adults, solid malignancy is expected to be identified in less than 20% of the cases. Currently only one case of endometrial carcinoma presenting with chylous ascites was described in a systematic review