A case of corpus cancer presenting with positive urine cytology

A 76-year-old woman was admitted with a chief complaint of gross hematuria. Although no abnormality was found on excretory pyelography, class IV transitional cell carcinoma was suspected based on urinary cytology. However, no malignancy was observed on cystoscopy or on biopsy of the mucosa of the urinary bladder. Thereafter, class IV or class V carcinoma was continuously found by urinary cytology, and cervical lymphadenopathy was also observed. Since computed tomography showed the uterus enhanced heterogenously, the possibility of a gynecological tumor was considered. Poorly differentiated endometrioid adenocarcinoma was found on histological examination of the endometrium, and similar adenocarcinoma was also found on biopsy of cervical lymph node. Furthermore, infiltration of adenocarcinoma into the proper lamina of urinary bladder was found. These findings suggested that this tumor originated in the uterine body, followed by lymph node metastasis and infiltration into the urinary bladder. Concerning the route of emergence of carcinoma cells in urine, joining in urine via vagina seemed most likely. When malignant cells are found in urine, tumors of the urinary system should primarily be suspected, but at the same time, the possibility of a gynecological tumor should be kept in mind.