[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-444311-105":59,"doc-detail-444311-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","cannonball-metastases-of-the-lung-an-unusual-initial-manifestation-of-endometrial-carcinoma","Cannonball Metastases of the Lung - An Unusual Initial Manifestation of Endometrial Carcinoma","","Endometrial carcinoma is the most common gynecologic malignancy in developed countries and is typically identified early, while distant metastases are uncommon at presentation. Pulmonary involvement occurs in under 5% and usually shows small nodules or interstitial disease; multiple large round “cannonball” metastases are exceptionally rare. We report a 60-year-old woman with cough and dyspnea whose imaging showed widespread bilateral cannonball nodules, mediastinal lymphadenopathy, hepatic lesions, and an enlarged uterus. Endometrial biopsy confirmed endometrioid adenocarcinoma staged as FIGO IV-B. Carboplatin and paclitaxel chemotherapy produced significant regression of pulmonary and hepatic metastases and symptom improvement, followed by anastrozole maintenance achieving stable disease.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/cannonball-metastases-of-the-lung-an-unusual-initial-manifestation-of-endometrial-carcinoma/444311/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/cannonball-metastases-of-the-lung-an-unusual-initial-manifestation-of-endometrial-carcinoma/444311.png","ImageObject",300,407,{"name":92,"@type":93},"Stanley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why are “cannonball” lung metastases from endometrial carcinoma clinically important?","Question",{"text":113,"@type":114},"They are exceptionally rare. Recognizing this radiographic pattern can support earlier diagnosis of endometrial carcinoma and guide timely treatment.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the diagnosis of endometrial cancer confirmed in the case?",{"text":118,"@type":114},"Endometrial biopsy showed endometrioid adenocarcinoma with squamous differentiation, and staging was consistent with FIGO IV-B.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatment did the patient receive and what was the outcome?",{"text":122,"@type":114},"She received chemotherapy with carboplatin and paclitaxel, leading to significant regression of pulmonary and hepatic metastases and symptomatic improvement. Maintenance therapy with anastrozole achieved stable disease on surveillance.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},444311,1790887401,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":39,"preview_page_count":4},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Respirology Case Reports  \nCASE REPORT  OPEN ACCESS   \nCannonball Metastases of the Lung: An Unusual Initial Manifestation of Endometrial Carcinoma  \nMidila Bapineni1 | Shivendra Tangutoori1 | Naga Vamsi Krishna Machineni1 | Kamlesh Sajnani2 | Maneesh Gaddam3   \n1Department of Internal Medicine, Appalachian Regional Healthcare, Harlan, Kentucky, USA | 2Department of Hematology and Oncology, Appalachian Regional Healthcare, Harlan, Kentucky, USA | 3Department of Pulmonary, Critical Care and Sleep Medicine, Appalachian Regional Healthcare, Hazard, Kentucky, USA  \nCorrespondence: Maneesh Gaddam ([drmaneeshgaddam@gmail.com](drmaneeshgaddam@gmail.com))  \nReceived: 11 September 2025 | Revised: 9 December 2025 | Accepted: 13 December 2025  \nAssociate Editor: Panwen Tian  \nKeywords: cannonball lesions | endometrial carcinoma | lung nodules | malignancy | metastasis  \nABSTRACT  \nEndometrial 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 ofa 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.  \n1 | Introduction  \nEndometrial carcinoma is the most common gynecologic malignancy in developed countries and a leading cancer among women worldwide [1] . Most cases are detected early due to abnormal uterine bleeding, especially in postmenopausal women, and have favorable outcomes with five-year survival exceeding 90% . In contrast, advanced or metastatic disease is less common and carries a markedly worse prognosis, with pulmonary metastases reported in only 2.3%–4.7% of patients [2, 3] . These metastases usually appear as small nodules or interstitial changes; large, well-defined ‘cannonball’ lesions are exceedingly rare. The term ‘cannonball metastases’describes multiple, round, sharply circumscribed pulmonary nodules resembling historical artillery fire and is classically associated with renal cell  \ncarcinoma, choriocarcinoma, and occasionally breast or colorectal carcinoma [4, 5] . Infectious or autoimmune conditions may mimic this radiographic pattern, but gynecologic primaries seldom do. We report a rare case of endometrial carcinoma that initially presented with respiratory symptoms, where progressive cough and dyspnea led to the discovery of widespread cannonball pulmonary metastases on imaging.  \n2 | Case Report  \nA 60-year-old woman with no prior medical history and a lifetime non-smoker presented to her primary physician with a persistent nonproductive cough. She was empirically treated with antibiotics for presumed bronchitis, but her symptoms persisted  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2026 The Author(s). Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.  \nRespirology Case Reports, 2026; 14:e70455 1 of 3  \n[https://doi.org/10.1002/rcr2.70455](https://doi.org/10.100","cbCainLz6QFOJ4iJ","https://ap.wps.com/l/cbCainLz6QFOJ4iJ","pdf",560178,"English","# Abstract\n# Introduction\n# Case Report","[{\"question\":\"Why are “cannonball” lung metastases from endometrial carcinoma clinically important?\",\"answer\":\"They are exceptionally rare. Recognizing this radiographic pattern can support earlier diagnosis of endometrial carcinoma and guide timely treatment.\"},{\"question\":\"How was the diagnosis of endometrial cancer confirmed in the case?\",\"answer\":\"Endometrial biopsy showed endometrioid adenocarcinoma with squamous differentiation, and staging was consistent with FIGO IV-B.\"},{\"question\":\"What treatment did the patient receive and what was the outcome?\",\"answer\":\"She received chemotherapy with carboplatin and paclitaxel, leading to significant regression of pulmonary and hepatic metastases and symptomatic improvement. Maintenance therapy with anastrozole achieved stable disease on surveillance.\"}]","Cannonball Metastases of the Lung - An Unusual Initial Manifestation of Endometrial Carcinoma | PDF",1790707509]