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Abughazaleh S, Tarawneh M, Alzghoul H, Alsakarneh S, Saleh O, Mir WAY. A case report of lung metastasis in a cervical cancer presenting as a consolidation. Radiol Case Rep 2024; 19:1144-1148. [PMID: 38234387 PMCID: PMC10793090 DOI: 10.1016/j.radcr.2023.11.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
Cervical cancer is a preventable cancer in the United States. We discuss a case of a 43-year-old woman who presented with signs and symptoms of Cerebrovascular accident (CVA) as well as shortness of breath and chest tightness. Upon investigation, it was concluded that she had developed multiple brain infarcts, pulmonary embolism, and deep venous thrombosis in both lower extremities. However, after her pulmonary symptoms worsened, further investigations revealed an uncommon occurrence of infiltrative lung metastasis. This finding was particularly surprising as she had recently been diagnosed with squamous cell carcinoma of the cervix. It is important to note that patients who have not undergone regular cervical cancer screening can remain without symptoms until the disease has reached an advanced stage, as is the case with this patient. Various screening methods, such as Pap smear cytology, human papillomavirus (HPV) DNA testing, and visual inspection tests, are available to detect and prevent cervical cancer.
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Affiliation(s)
- Saeed Abughazaleh
- St. Elizabeth's Medical Center, Tufts University School of Medicine, Brighton, MA, USA
| | - Mohammad Tarawneh
- St. Elizabeth's Medical Center, Tufts University School of Medicine, Brighton, MA, USA
| | - Hamza Alzghoul
- University of Central Florida College of Medicine, Graduate Medical Education Orlando, FL, USA
- North Florida Regional Medical Center, Internal Medicine Residency Program, Gainesville, FL, USA
| | | | - Othman Saleh
- Hashemite University School of Medicine, Zarqa, Jordan
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Khaja M, Yapor L, Haider A, Anwar MY, Ronderos DM, Shin D. A Case of Malignant Pleural Effusion Secondary to Endometrial Cancer After One Year of Hysterectomy. Cureus 2022; 14:e28907. [PMID: 36237771 PMCID: PMC9546637 DOI: 10.7759/cureus.28907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/05/2022] Open
Abstract
Endometrial cancer is the most common malignant tumor of the female genital tract. It can rarely metastasize to the lung, presenting as a pulmonary nodule and pleural effusion. Here we present a case of a 76-year-old female with a history of endometrial cancer who underwent a total abdominal hysterectomy and came one year later for evaluation of shortness of breath. She was found to have pleural effusion. Diagnostic and therapeutic thoracentesis was positive for malignant cells originating from endometrial cancer. The patient could not tolerate chemotherapy due to poor functional status, and a tunnel pleural catheter was placed for symptomatic relief. In conclusion, it is a rare finding of malignant pleural effusion to have an origin as endometrial cancer. Pleura is the rare distant site of involvement from endometrial cancer.
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Marshall C, Rajdev MA, Somarouthu B, Ramaiya NH, Alessandrino F. Overview of systemic treatment in recurrent and advanced cervical cancer: a primer for radiologists. Abdom Radiol (NY) 2019; 44:1506-1519. [PMID: 30288585 DOI: 10.1007/s00261-018-1797-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Imaging has a central role in surveillance of cervical cancer, guiding decision on when to initiate treatment for recurrent disease and to guide management in advanced cervical cancer. Due to the increased availability of pelvic radiation therapy, the rate of atypical presentation of recurrent disease has increased. Simultaneously, the array of systemic therapies now available for advanced cervical cancer has considerably expanded in the last few years, with therapies now available in mid and low-income countries. While pelvic recurrences are amenable of loco-regional treatment, recurrent disease may present with metastases to the thoracoabdominal organs, lymph nodes, bones, skin and brain, for which systemic treatment represent the standard of care. Besides combined chemotherapy regimens, alternative chemotherapies, biosimilars and immune checkpoint inhibitors are now available, each associated with a definite pattern of response and toxicity. In this review, after describing the typical and atypical presentations of recurrent and advanced cervical carcinoma on cross-sectional imaging, we will discuss systemic treatment for recurrent or advanced disease and their associated radiographic sequelae, in light of the newly available therapies.
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Kishore M, Kaushal M, Ahuja A. Endometrial carcinoma with pleural fluid metastasis: A rare phenomenon. Cytojournal 2018; 15:25. [PMID: 30410562 PMCID: PMC6198706 DOI: 10.4103/cytojournal.cytojournal_28_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 08/09/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Manjari Kishore
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manju Kaushal
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arvind Ahuja
- Address: Department of Pathology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Martínez-Jiménez S, Rosado-de-Christenson ML, Walker CM, Kunin JR, Betancourt SL, Shoup BL, Pettavel PP. Imaging features of thoracic metastases from gynecologic neoplasms. Radiographics 2015; 34:1742-54. [PMID: 25310428 DOI: 10.1148/rg.346140052] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Gynecologic malignancies are a heterogeneous group of common neoplasms and represent the fourth most common malignancy in women. Thoracic metastases exhibit various imaging patterns and are usually associated with locally invasive primary neoplasms with intra-abdominal spread. However, thoracic involvement may also occur many months to years after initial diagnosis or as an isolated finding in patients without evidence of intra-abdominal neoplastic involvement. Thoracic metastases from endometrial carcinoma typically manifest as pulmonary nodules and lymphadenopathy. Thoracic metastases from ovarian cancer often manifest with small pleural effusions and subtle pleural nodules. Thoracic metastases to the lungs, lymph nodes, and pleura may also exhibit calcification and mimic granulomatous disease. Metastases from fallopian tube carcinomas exhibit imaging features identical to those of ovarian cancers. Most cervical cancers are of squamous histology, and while solid pulmonary metastases are more common, cavitary metastases occur with some frequency. Metastatic choriocarcinoma to the lung characteristically manifests with solid pulmonary nodules. Some pulmonary metastases from gynecologic malignancies exhibit characteristic features such as cavitation (in squamous cell cervical cancer) and the "halo" sign (in hemorrhagic metastatic choriocarcinoma) at computed tomography (CT). However, metastases from common gynecologic malignancies may be subtle and indolent and may mimic benign conditions such as intrapulmonary lymph nodes and remote granulomatous disease. Therefore, radiologists should consider the presence of locoregional disease as well as elevated tumor marker levels when interpreting imaging studies because subtle imaging findings may represent metastatic disease. Positron emission tomography/CT may be helpful in identifying early locoregional and distant tumor spread.
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Affiliation(s)
- Santiago Martínez-Jiménez
- From the Department of Radiology (S.M.J., M.L.R.d.C., C.M.W., J.R.K.), Department of Gynecology and Obstetrics, Division of Gynecologic Oncology (B.L.S.), and Department of Pathology (P.P.P.), Saint Luke's Hospital of Kansas City, University of Missouri in Kansas City, 4401 Wornall Rd, Kansas City, MO 64111; and Department of Radiology, MD Anderson Cancer Center, University of Texas, Houston, Tex (S.L.B.)
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Khashper A, Gruber JM, Fraser RS, Discepola F, Semionov A. Review of Thoracic Imaging Findings Unique to Women. Can Assoc Radiol J 2015; 66:223-30. [PMID: 25770629 DOI: 10.1016/j.carj.2014.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 11/19/2014] [Accepted: 11/26/2014] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Traditionally, indications for imaging studies of women are considered to be related to screening for and evaluation of disease of the female breast and pelvis. However, a number of chest diseases and associated intrathoracic imaging findings are unique to women and should be recognized by general radiologists, as well as chest and women-imaging specialists. CONCLUSIONS The sex-specific findings unique to women include normal anatomical variants, primary lung disease, complications of breast and gynaecological disease, and pregnancy-related conditions. Classification, description, and illustration of gender-specific chest imaging findings are the objective of this article.
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Affiliation(s)
- Alla Khashper
- Department of Radiology, McGill University Health Centre, Montréal, Québec, Canada.
| | - James M Gruber
- Department of Pulmonology, McGill University Health Centre, Montréal, Québec, Canada
| | - Richard S Fraser
- Department of Pathology, McGill University Health Centre, Montréal, Québec, Canada
| | - Federico Discepola
- Department of Radiology, Jewish General Hospital, Montréal, Québec, Canada
| | - Alexandre Semionov
- Department of Radiology, McGill University Health Centre, Montréal, Québec, Canada
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Miranda CMNRD, Santos CJJD, Maranhão CPDM, Farias LDPGD, Padilha IG, Andrade ACMD, Jatobá MSDA. A tomografia computadorizada multislice é ferramenta importante para o estadiamento e seguimento do câncer de mama? Radiol Bras 2012. [DOI: 10.1590/s0100-39842012000200009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
O câncer de mama representa o tipo de câncer mais comum em mulheres e constitui a primeira causa de morte por câncer nesta população. As alterações extramamárias relacionadas ao câncer de mama desempenham papel relevante no prognóstico e tratamento desta entidade, sendo fundamental a realização do diagnóstico correto e das diversas alterações. A maioria dessas manifestações é proveniente do tratamento adotado ou de suas complicações e pode estar associada a comprometimento linfonodal, recorrência locorregional ou metástases a distância.
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Kanthan R, Senger JLB, Diudea D. Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix. World J Surg Oncol 2010; 8:107. [PMID: 21129213 PMCID: PMC3006383 DOI: 10.1186/1477-7819-8-107] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 12/03/2010] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Pulmonary metastasis presenting as lymphangitic carcinomatosis arising from squamous cell carcinoma (SCC) of the cervix is a rare event. Poorly represented in the literature, this event is associated with a) difficulty in accurate diagnosis, b) grave prognosis, and the c) lack of recognized predisposing risk factors. CASE REPORT A 50 year-old female presented at our practice with a three-month history of a productive cough associated with dyspnoea and shortness of breath. A chest x-ray and computed tomography (CT) scan revealed multiple bilateral patchy areas with subsegmental atelectasis in both lungs which was investigated with a bronchoscopy, left thoracoscopy, and a left lung biopsy. Pathological examination of the wedge biopsy of the left upper lobe revealed neoplastic sheets of cell disturbed along the septal vessels, perivascular/peribronchial lymphatics, and the subpleural lymphatics. This lymphangitic carcinomatosis was confirmed to be metastatic from SCC of the cervix that had been diagnosed and treated two years ago. She was treated with systemic Carbo/Taxol chemotherapy and corticosteroids as a palliative measure. Despite temporary improvement, she died 13 months later. CONCLUSION Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic SCC of the cervix. As clinical presentations including radiographic imaging mimics other pulmonary entities, accurate diagnosis remains a challenge. Increased clinical awareness of such patterns of metastases in cervical cancer supported by accurate pathological diagnosis is imperative to guide appropriate therapy in these patients.
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Affiliation(s)
- Rani Kanthan
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
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Acikgoz G, Kim SM, Houseni M, Cermik TF, Intenzo CM, Alavi A. Pulmonary lymphangitic carcinomatosis (PLC): spectrum of FDG-PET findings. Clin Nucl Med 2007; 31:673-8. [PMID: 17053382 DOI: 10.1097/01.rlu.0000242210.99022.fd] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The lungs are among the most common sites for metastases from a multitude of cancers. The majority of pulmonary metastases appear nodular on radiologic images. Interstitial spread of tumor through pulmonary lymphatics, also known as pulmonary lymphangitic carcinomatosis (PLC), is not uncommon and constitutes approximately 7% of pulmonary metastases. PLC is most often seen with adenocarcinoma of a variety of histologies such as thyroid carcinoma, and melanoma. It is usually noted in late stages of malignancy and therefore is indicative of a poor prognosis. Diagnosis of PLC is usually based on a combination of clinical and radiologic findings. However, the diagnosis is difficult when patients have limited clinical findings or have a history of or the possibility of other interstitial lung diseases. High-resolution computed tomography (HRCT) has been the modality of choice in the radiologic diagnosis of PLC. Imaging features of PLC on HRCT include thickening of interlobular septa, fissures, and bronchovascular bundles. Distribution of PLC may be focal or diffuse, unilateral or bilateral, and symmetric or asymmetric. Although FDG-PET has been extensively used in primary or secondary lung malignancies, its role and appearance in PLC have not been well determined in the literature. In this communication, we describe a spectrum of FDG-PET and CT findings in 5 cases with PLC. Similar to CT, the distribution of PLC can be extensive or limited on the FDG-PET. Diffuse, lobar, or segmental FDG uptake in the lungs is seen in extensive PLC. In limited PLC, a linear or a hazy area of FDG uptake extending from the tumor can be seen. Recognition of various patterns related to PLC on FDG-PET may allow accurate diagnosis of disease and could potentially influence the management of these patients.
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Affiliation(s)
- Gunsel Acikgoz
- Division of Nuclear Medicine, Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA.
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