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Omori M, Ogawa T, Oyama K, Tagaya H, Fukasawa H, Hirata S. Leptomeningeal metastasis from cervical cancer: Report of two cases and a review of the literature. J Obstet Gynaecol Res 2021; 47:2782-2789. [PMID: 34002430 DOI: 10.1111/jog.14825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/02/2021] [Accepted: 04/30/2021] [Indexed: 12/01/2022]
Abstract
Leptomeningeal metastases from cervical cancer are extremely rare, with only 24 cases reported in the English-language literature. Leptomeningeal metastasis (LM) is usually a late event, but it can develop at any stage. A 44-year-old woman presented with vertigo, tinnitus, diminution of hearing, and a cervical tumor at the initial visit. She underwent whole brain radiotherapy and systemic chemotherapy. Five months after the initial visit, her condition deteriorated rapidly and she died. A 49-year-old woman underwent surgery and pelvic radiotherapy for cervical cancer. She underwent resection of lung metastases 2 years later and received systemic chemotherapy for lymph node metastases 4 years later. Five years after the initial visit, the patient suddenly presented with diplopia, headache, and vomiting; her clinical course was fulminant and she died. Most patients with LM present with diverse clinical manifestations and deteriorate rapidly despite multiple treatment modalities. Gynecologic oncologists should be aware of this rare complication.
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Affiliation(s)
- Makiko Omori
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Tatsuyuki Ogawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Keisuke Oyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hikaru Tagaya
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hiroko Fukasawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Shuji Hirata
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
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Brain Metastases from Uterine Cervical and Endometrial Cancer. Cancers (Basel) 2021; 13:cancers13030519. [PMID: 33572880 PMCID: PMC7866278 DOI: 10.3390/cancers13030519] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 12/30/2022] Open
Abstract
Simple Summary This review investigated the prevalence, clinical characteristics, clinical presentation, diagnosis, treatment, and prognosis of patients with brain metastases from uterine cervical carcinoma (CC) and uterine endometrial carcinoma (EC). The findings of this review indicate the factors that can facilitate better treatment selection and, consequently, better outcomes in patients with CC and EC. Abstract Reports on brain metastases (BMs) from uterine cervical carcinoma (CC) and uterine endometrial carcinoma (EC) have recently increased due to the development of massive databases and improvements in diagnostic procedures. This review separately investigates the prevalence, clinical characteristics, clinical presentation, diagnosis, treatment, and prognosis of BMs from CC and uterine endometrial carcinoma EC. For patients with CC, early-stage disease and poorly differentiated carcinoma lead to BMs, and elderly age, poor performance status, and multiple BMs are listed as poor prognostic factors. Advanced-stage disease and high-grade carcinoma are high-risk factors for BMs from EC, and multiple metastases and extracranial metastases, or unimodal therapies, are possibly factors indicating poor prognosis. There is no “most effective” therapy that has gained consensus for the treatment of BMs. Treatment decisions are based on clinical status, number of the metastases, tumor size, and metastases at distant organs. Surgical resection followed by adjuvant radiotherapy appears to be the best treatment approach to date. Stereotactic ablative radiation therapy has been increasingly associated with good outcomes in preserving cognitive functions. Despite treatment, patients died within 1 year after the BM diagnosis. BMs from uterine cancer remain quite rare, and the current evidence is limited; thus, further studies are needed.
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Bandinelli MB, Viezzer Bianchi M, Wronski JG, Santos de Mello L, Blanco DeMartini R, Savi C, Sonne L, Driemeier D, Petinatti Pavarini S. Ophthalmopathologic characterization of multicentric or metastatic neoplasms with an extraocular origin in dogs and cats. Vet Ophthalmol 2020; 23:814-827. [PMID: 32687655 DOI: 10.1111/vop.12803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 05/31/2020] [Accepted: 06/17/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To characterize the frequency and distribution of secondary ocular neoplasms in dogs and cats identified during necropsy. METHODS A retrospective analysis of necropsy records of dogs and cats was conducted, and cases with metastatic/multicentric neoplasms with an extraocular origin, involving the eyes, were selected. RESULTS From January 2015 to January 2019, we identified a total of 233 dogs and 100 cats with metastatic disease. Of these, 11.6% (27/233) of the dogs and 13% (13/100) of the cats had ocular metastases. Lymphoma was the most common multicentric neoplasm involving the eyes of both species. In dogs, these neoplasms occurred bilaterally, predominantly in the anterior uvea, and were diffuse large B-cell, T-lymphoblastic, peripheral T-cell not otherwise specified, and lymphocytic B-cell lymphomas. In cats, feline leukemia virus (FeLV)-associated T-cell lymphoma was the most common. Mammary carcinoma was the second most common ocular metastatic neoplasm in bitches, with a predominantly unilateral involvement of the uveal tract. In cats, following lymphoma, pulmonary and squamous cell carcinomas were the most common multicentric/metastatic neoplasms of the eyes. Individual cases of cholangiocarcinoma, hemangiosarcoma, and chemodectoma in dogs, as well as mammary gland cribriform carcinoma, salivary gland carcinoma, and histiocytic sarcoma in cats were detected. CONCLUSIONS The eyes of dogs were mostly affected by lymphoma or mammary gland carcinoma, while those of cats mostly had lymphoma, pulmonary carcinoma, or squamous cell carcinoma as the main metastatic/multicentric neoplasm. To the best of our knowledge, this is the first study to identify intraocular metastatic cholangiocarcinoma and chemodectoma in dogs, aside from identifying salivary gland carcinoma in cats.
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Affiliation(s)
- Marcele Bettim Bandinelli
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Matheus Viezzer Bianchi
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Júlia Gabriela Wronski
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lauren Santos de Mello
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Renata Blanco DeMartini
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Caroline Savi
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciana Sonne
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - David Driemeier
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Saulo Petinatti Pavarini
- Department of Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Branch BC, Henry J, Vecil GG. Brain Metastases from Cervical Cancer – a Short Review. TUMORI JOURNAL 2018. [DOI: 10.1177/1660.18186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Byron C Branch
- Departments of Neurosurgery, University of Texas Health Science Center, San Antonio, Texas, USA
| | - James Henry
- Departments of Pathology, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Giacomo G Vecil
- Departments of Neurosurgery, University of Texas Health Science Center, San Antonio, Texas, USA
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Toyoshima M, Tsuji K, Shigeta S, Tokunaga H, Ito K, Watanabe Y, Yoshinaga K, Otsuki T, Niikura H, Yaegashi N. Leptomeningeal metastasis from gynecologic cancers diagnosed by brain MRI. Clin Imaging 2017; 41:42-47. [DOI: 10.1016/j.clinimag.2016.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/23/2016] [Accepted: 09/26/2016] [Indexed: 11/25/2022]
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Cheng HC, Yeh HJ, Huang N, Chou YJ, Yen MY, Wang AG. Amiodarone-Associated Optic Neuropathy. Ophthalmology 2015; 122:2553-9. [DOI: 10.1016/j.ophtha.2015.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 08/04/2015] [Accepted: 08/15/2015] [Indexed: 11/16/2022] Open
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Oike T, Ohno T, Noda SE, Murata T, Hirakawa T, Hirato J, Furuya M, Sato H, Hirota Y, Minegishi T, Nakano T. Leptomeningeal metastasis of uterine cervical cancer 17 years after primary tumor treatment. Clin Case Rep 2015; 4:54-61. [PMID: 26783437 PMCID: PMC4706399 DOI: 10.1002/ccr3.445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 09/07/2015] [Accepted: 10/14/2015] [Indexed: 11/06/2022] Open
Abstract
Leptomeningeal metastasis (LM) of uterine cervical cancer is extremely rare. A 54-year-old woman with uterine cervical cancer treated with surgery and radiotherapy developed LM manifesting as ptosis 17 years later. Although rare, LM should be considered in patients with a history of uterine cervical cancer presenting with cranial nerve symptoms.
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Affiliation(s)
- Takahiro Oike
- Department of Radiation Oncology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Tatsuya Ohno
- Department of Radiation Oncology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Shin-Ei Noda
- Department of Radiation Oncology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Tomomi Murata
- Department of Obstetrics and Gynecology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Takashi Hirakawa
- Department of Obstetrics and Gynecology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Junko Hirato
- Department of Pathology Gunma University Hospital 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Mio Furuya
- Department of Pathology Gunma University Hospital 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Hiro Sato
- Department of Radiation Oncology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Yuka Hirota
- Department of Radiation Oncology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Takashi Minegishi
- Department of Obstetrics and Gynecology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
| | - Takashi Nakano
- Department of Radiation Oncology Gunma University Graduate School of Medicine 3-39-22 Showa-machi Maebashi Gunma 371-8511 Japan
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Oumerzouk J, Ahmimeche J, Hanafi Y, El Khiyat I, Nasri A, Bourazza A. Un œdème papillaire bilatéral d’aggravation rapide, révélant une méningite carcinomateuse. À propos d’un cas et revue de la littérature. J Fr Ophtalmol 2013; 36:e183-5. [DOI: 10.1016/j.jfo.2013.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/04/2013] [Accepted: 04/26/2013] [Indexed: 11/30/2022]
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Optic neuritis as isolated manifestation of leptomeningeal carcinomatosis: a case report and systematic review of ocular manifestations of neoplastic meningitis. Neurol Res Int 2013; 2013:892523. [PMID: 24223306 PMCID: PMC3816070 DOI: 10.1155/2013/892523] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 08/30/2013] [Accepted: 08/31/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction. Leptomeningeal carcinomatosis occurs in about 5% of cancer patients. Ocular involvement is a common clinical manifestation and often the presenting clinical feature. Materials and Methods. We report the case of a 52-year old lady with optic neuritis as isolated manifestation of neoplastic meningitis and a review of ocular involvement in neoplastic meningitis. Ocular symptoms were the presenting clinical feature in 34 patients (83%) out of 41 included in our review, the unique manifestation of meningeal carcinomatosis in 3 patients (7%). Visual loss was the presenting clinical manifestation in 17 patients (50%) and was the most common ocular symptom (70%). Other ocular signs were diplopia, ptosis, papilledema, anisocoria, exophthalmos, orbital pain, scotomas, hemianopsia, and nystagmus. Associated clinical symptoms were headache, altered consciousness, meningism, limb weakness, ataxia, dizziness, seizures, and other cranial nerves involvement. All patients except five underwent CSF examination which was normal in 1 patient, pleocytosis was found in 11 patients, increased protein levels were observed in 16 patients, and decreased glucose levels were found in 8 patients. Cytology was positive in 29 patients (76%). Conclusion. Meningeal carcinomatosis should be considered in patients with ocular symptoms even in the absence of other suggestive clinical symptoms.
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Watanabe Y, Nakai H, Imaoka I, Murakami T, Hoshiai H. Carcinomatous meningitis during systematic chemotherapy in a patient with advanced small-cell neuroendocrine carcinoma of the uterine cervix. J Obstet Gynaecol Res 2011; 38:336-9. [DOI: 10.1111/j.1447-0756.2011.01634.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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A case of primary uterine cervical neuroendocrine tumor with meningeal carcinomatosis confirmed by diagnostic imaging and autopsy. Int J Clin Oncol 2010; 16:581-6. [DOI: 10.1007/s10147-010-0155-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 11/16/2010] [Indexed: 10/18/2022]
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Devkota B, Patel H. Meningeal carcinomatosis from cervical cancer: a case report and review of the literature. Hosp Pract (1995) 2010; 38:117-21. [PMID: 20890060 DOI: 10.3810/hp.2010.06.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Meningeal carcinomatosis (MC) from cervical cancer is rare. Diagnosis of this disease is often delayed due to variable presentation. We report an interesting case of MC from the uterine cervix and review general diagnostic and treatment considerations. The patient received chemotherapy and radiotherapy for stage IIB cervical cancer with resolution of symptoms for 3 years. Metastatic lesions were found in the right lung and paraaotic nodes on follow-up positron emission tomography scan, which completely resolved with subsequent chemotherapy. Unfortunately, the patient developed neurological symptoms consistent with MC, which was confirmed by cerebrospinal fluid cytology. Because of her poor cognition, available options were discussed with her family. She died peacefully in palliative care.
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Squamous cell carcinomatous meningitis. Oncol Rev 2009. [DOI: 10.1007/s12156-009-0018-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Asensio N, Luis A, Costa I, Oliveira J, Vaz F. Meningeal carcinomatosis and uterine carcinoma: three different clinical settings and review of the literature. Int J Gynecol Cancer 2009; 19:168-72. [PMID: 19258961 DOI: 10.1111/igc.0b013e31819a1e1a] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Leptomeningeal carcinomatosis is a rare metastatic event in gynecological neoplasias, and most cases occur in ovarian cancer. It is extremely infrequent in cervical cancer, and so far, there are not any reports of this complication in association with endometrial cancer. PATIENTS AND METHODS We report a case of leptomeningeal carcinomatosis secondary to endometrial carcinoma and 2 complex cervix cancer cases. A MEDLINE search was done to review all published cases of this complication in gynecological cancer to identify predictive factors for this diagnosis. RESULTS AND DISCUSSION Leptomeningeal carcinomatosis is usually diagnosed late in the course of the disease, and most reports concern ovarian cancer patients. The number of cases describing this neurologic complication in cervix cancer is increasing. Gadolinium-enhanced magnetic resonance imaging may be necessary for this diagnosis, because cerebrospinal fluid analysis results may be negative. Most cervix cases had squamous cell (8/14) or neuroendocrine histologic subtype (3/14), and when reported, differentiation was usually poor. The case we report of endometrial carcinoma, unique in the literature, is a serous adenocarcinoma. CONCLUSIONS A high index of suspicion is necessary, and leptomeningeal carcinomatosis should be considered in patients with unexplained neurologic symptoms whose gynecologic tumors are poorly undifferentiated or have a serous component.
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Affiliation(s)
- Nuria Asensio
- Medical Oncology; and daggerNeurology Departments, Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal
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Ignatius RT, Wills SM, Nadeau L, Deperalta-Venturina M, Weiner S. Leptomeningeal carcinomatosis due to squamous cell carcinoma of the uterine cervix associated with HPV-45. J Clin Oncol 2008; 26:154-6. [PMID: 18165650 DOI: 10.1200/jco.2007.14.3180] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Renjitha T Ignatius
- Department of Internal Medicine, Division of Hematology/Oncology, William Beaumont Hospital, Royal Oak, MI, USA
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Han L, Bhan R, Johnson S, Zak I, Husain M, Al-Abbadi MA. Leptomeningeal metastasis in a patient with squamous cell carcinoma of the uterine cervix: Report of a case and review of the literature. Diagn Cytopathol 2007; 35:660-2. [PMID: 17854087 DOI: 10.1002/dc.20705] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Leptomeningeal spread of advanced squamous cell carcinoma (SCC) of the uterine cervix is unusual. To our knowledge, very few cases were reported in the English literature. We report a case of a 39-yr-old woman who presented with leptomeningeal metastasis from a stage IIb SCC of uterine cervix. The diagnosis was made by cytomorphological examination of smears obtained from cerebrospinal fluid. The cytomorphological features are demonstrated.
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Affiliation(s)
- Liying Han
- Department of Pathology, Wayne State University and Karmanos Cancer Institute, Detroit, Michigan 48201, USA
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