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Le CT, Nguyen AQ, Thi Pham HD, Tran LT, Van Truong H, Nguyen DB, Tran HV, Nguyen DD. Recurrent early-stage squamous cell carcinoma cervical cancer presenting with isolated ovary metastasis: a rare case report. Ann Med Surg (Lond) 2023; 85:5662-5665. [PMID: 37915691 PMCID: PMC10617924 DOI: 10.1097/ms9.0000000000001273] [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: 07/21/2023] [Accepted: 08/25/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Ovarian metastatic squamous carcinoma of the cervix is rare, accounting for about 0.4%. This study reports a single case of metastatic recurrent cervical cancer in the ovary. Case presentation A 46-year-old patient with a history of cervical cancer T1b2N0M0 underwent a radical hysterectomy, bilateral pelvic lymph node dissection, and ovarian preservation. One year later, the patient was admitted to the hospital because of abdominal pain in the left iliac fossa; the abdominal computed tomography image showed a left ovarian tumour. The patient underwent laparoscopic left oophorectomy. Postoperative histopathology confirmed ovarian squamous cell carcinoma. From this case, we would like to review the literature on epidemiology, diagnosis, treatment, and prognosis. Clinical discussion Ovarian preservation during surgery in patients with cervical cancer offers many benefits, but careful patient selection is required. However, it should be selected carefully and closely monitored. Conclusions Clinicians should be aware of this situation of ovarian metastasis in patients with early cervical cancer undergoing ovarian-conserving surgery.
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Affiliation(s)
| | | | | | | | - Hop Van Truong
- Vietnam National Cancer Hospital
- Hanoi Medical University, Hanoi, Vietnam
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Tong L, Wu L. Unilateral ovarian recurrence 5 years after hysterectomy for microinvasive squamous cervical cancer stage IA1: a rare case report. BMC Womens Health 2023; 23:350. [PMID: 37393247 PMCID: PMC10315017 DOI: 10.1186/s12905-023-02496-9] [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: 08/26/2022] [Accepted: 06/20/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Ovarian metastasis or recurrence of cervical microinvasive squamous cell carcinoma (SCC) is very rare. We report a case of unilateral ovarian recurrence 5 years after hysterectomy for the SCC stage IA1 without lymph vascular space invasion (LVSI). CASE PRESENTATION A 49-year-old female patient suffered from a dull pain in the left lower abdomen for 3 months. And five years ago, she received a laparoscopic hysterectomy for the treatment of stage IA1 (without LVSI) SCC of the cervix. The level of squamous cell carcinoma antigen (SCC-Ag) in serum was significantly elevated (10.60 ng/mL). Pelvic magnetic resonance imaging (MRI) revealed a left ovarian solid tumor measuring 5.5 × 3.9 × 5.6 cm with heterogeneous enhancement. During laparotomy, the left ovarian tumor was measured about 5.0 × 4.5 × 3.0 cm and seemed densely adherent to the posterior peritoneal wall, including the left ureter. The tumor and pelvic lymph node were carefully removed. Postoperative anatomy revealed a solid mass with a greyish-white section. Postoperative pathology showed recurrent moderately differentiated ovarian SCC with negative pelvic lymph nodes. Immunohistochemistry showed that the tumor cells were positive for P16, P63, P40, and CK5/6 markers, and the positive rate of Ki67 was about 80%. CONCLUSIONS Ovary preservation is reasonable and appropriate in young patients with microinvasive SCC. Ovarian recurrence is rare, but gynecological oncologists should not overlook its possibility. The serum SCC-Ag is an important indicator for monitoring postoperative disease progression.
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Affiliation(s)
- Longxia Tong
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan Province, No. 20, 3Rd Section, South Renmin Road, Chengdu, 610041, China
| | - Lin Wu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan Province, No. 20, 3Rd Section, South Renmin Road, Chengdu, 610041, China.
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Metastatic Cutaneous Squamous Cell Cancer with Peritoneal Carcinomatosis: A Case Report. REPORTS 2019. [DOI: 10.3390/reports2010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Peritoneal involvement as a metastatic site of squamous cell skin cancer is exceptionally rare. The current work analyzes a 52-year old male with high-risk cutaneous squamous cell nose carcinoma (cSCC) that was initially treated with surgery and platinum-based concurrent chemoradiation. Five years later, he presented jaundice and hypercalcemia. Further imaging revealed diffused liver, peritoneal and paraaortic lymph node metastases without evidence of locoregional recurrence. The patient underwent liver biopsy, which confirmed the diagnosis. High-risk features for metastasizing can be considered the maximum clinical diameter, the anatomical subsite (localization of the primary tumor in the ear and retroauricular area, cheek and lip are considered to significantly increase the risk of distant metastasis), poor histological differentiation, perineural invasion and lesions with a thickness of more than 2.0 mm. Late relapse that involves only disseminated abdominal disease is very uncommon and may justify closer follow-up and more aggressive chemotherapy in high-risk patients.
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Secondary Involvement of the Adnexa and Uterine Corpus by Carcinomas of the Uterine Cervix: A Detailed Morphologic Description. Int J Gynecol Pathol 2016; 34:551-63. [PMID: 26166722 DOI: 10.1097/pgp.0000000000000206] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cervical carcinoma infrequently involves the uterine corpus or adnexa. Metastatic adenocarcinoma (AC) to the ovaries can be difficult to distinguish from primary ovarian tumors, and metastatic squamous cell carcinoma (SCC) to these sites has not been well described. Our aim was to provide a detailed description of the morphologic patterns of adnexal and corpus involvement by cervical carcinoma. Cases were identified over a 15-yr period and the following features were recorded: visible lesion, depth of invasion, lymphovascular invasion, and patterns of spread. Only usual human papillomavirus-associated tumors were included. Twenty cases with available slides were identified (2 in situ and 8 invasive SCC; 10 AC); 17 had visible lesions, usually with deep cervical and lymphovascular invasion. Sixteen involved the corpus (1 in situ, 7 SCC, 8 AC), all colonizing endometrium and 10 invading myometrium. SCC involved the ovary and fallopian tube in 4 and 6 cases, respectively, whereas AC involved the ovary in 4 (2 unilateral, 2 bilateral) and the tube in 8 cases. SCC in the ovary usually showed parenchymal invasion, and parenchymal and mucosal involvement in the tube. AC in the ovary ranged from small nodules to confluent expansile growth, whereas in the tube it often showed mucosal colonization mimicking a primary tubal process. Adnexal metastasis of cervical carcinoma is rare and usually coexists with endometrial and myometrial extension from the cervix. Both squamous and ACs can colonize tubal and endometrial mucosa; AC in particular can mimic primaries at those sites. Bilaterality is not a common feature of metastatic endocervical AC.
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Hecking T, Abramian A, Domröse C, Engeln T, Thiesler T, Leutner C, Gembruch U, Keyver-Paik MD, Kuhn W, Kübler K. Individual management of cervical cancer in pregnancy. Arch Gynecol Obstet 2016; 293:931-9. [PMID: 26728388 PMCID: PMC4829625 DOI: 10.1007/s00404-015-3980-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 12/01/2015] [Indexed: 12/29/2022]
Abstract
Purpose The management of cervical cancer in pregnancy persists to be challenging. Therefore, identification of factors that influence the choice of therapeutic management is pivotal for an adequate patient counseling. Methods We present a literature review of 26 studies reporting 121 pregnancies affected by cervical cancer. Additionally, we add a retrospective case series of five patients with pregnancy-associated cervical cancer diagnosed and treated in our clinic between 2006 and 2013. Results The literature review revealed that the therapeutic management during pregnancy varies according to the gestational age at diagnosis, while in the postpartum period no influence on the treatment choice could be detected. Also in our case series the choice of oncologic therapy was influenced by the gestational age, the wish to continue the pregnancy and the risks of delaying definitive treatment. Conclusions There are no standardized procedures concerning the treatment of cervical cancer in pregnancy. Therefore, in consultation with the patient and a multidisciplinary team, an adequate individualized treatment plan should be determined. Electronic supplementary material The online version of this article (doi:10.1007/s00404-015-3980-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thomas Hecking
- Department of Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Alina Abramian
- Department of Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Christian Domröse
- Department of Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Tabea Engeln
- Department of Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Thore Thiesler
- Institute of Pathology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Claudia Leutner
- Department of Radiology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Ulrich Gembruch
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Mignon-Denise Keyver-Paik
- Department of Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Walther Kuhn
- Department of Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Kirsten Kübler
- Department of Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany.
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Soda I, Ishiyama H, Ono S, Takenaka K, Arai M, Arai T, Iwase H, Sekiguchi A, Kawakami S, Komori S, Onda T, Hayakawa K. Assessment of transposed ovarian movement: how much of a safety margin should be added during pelvic radiotherapy? JOURNAL OF RADIATION RESEARCH 2015; 56:354-9. [PMID: 25589505 PMCID: PMC4380061 DOI: 10.1093/jrr/rru116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/23/2014] [Accepted: 11/10/2014] [Indexed: 05/25/2023]
Abstract
The purpose of this study was to analyze transposed ovarian movement. Data from 27 patients who underwent ovarian transposition after surgical treatment for uterine cancer were retrospectively analyzed. Computed tomography (CT) images including transposed ovaries were superimposed on other CT images acquired at different times, and were matched on bony structures. Differences in ovarian position between the CT images were measured. The planning organ at risk volume (PRV) margins were calculated from the formula of the 90% reference intervals (RIs) and the 95% RI, which were defined as mean ± 1.65 standard deviation (SD) and mean ± 1.96 SD, respectively. The 90% RI in the cranial, caudal, anterior, posterior, left and right directions were 1.5, 1.5, 1.4, 1.0, 1.7 and 0.9 cm, respectively. The 95% RI in the corresponding directions were 1.5, 2.0, 1.7, 1.2, 1.9 and 1.2 cm, respectively. These data suggest that bilateral ovaries need a PRV margin of ∼2 cm in all directions. The present study suggests that a transposed ovary needs the same PRV margin as a normal ovary (∼2 cm). Even after transposition, ovaries should be kept away from the radiation field to take into consideration the degree of ovarian movement.
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Affiliation(s)
- Itaru Soda
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Hiromichi Ishiyama
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Shigemitsu Ono
- Department of Gynecology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Kouji Takenaka
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Masahide Arai
- Department of Gynecology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Tsutomu Arai
- Department of Gynecology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Haruko Iwase
- Department of Gynecology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Akane Sekiguchi
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Shogo Kawakami
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Shouko Komori
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Takashi Onda
- Department of Gynecology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
| | - Kazushige Hayakawa
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
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Mahmood FM, Kadhim HS, Mousa Al Khuzaee LR. Detection of human papillomavirus-16 e6-oncoprotein in epithelial ovarian tumors samples of iraqi patients. Jundishapur J Microbiol 2014; 7:e11945. [PMID: 25485061 PMCID: PMC4255376 DOI: 10.5812/jjm.11945] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 09/01/2013] [Accepted: 10/14/2013] [Indexed: 11/17/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the causal factor for cervical cancer. However, the role of HPV infection in ovarian cancer is unclear. Objectives: This study aimed to determine the presence of human papillomavirus-16 (HPV-16) in ovarian tumor tissues. Patients and Methods: This was a retrospective study, which included 61 Archived human ovarian tumor tissues embedded in paraffin blocks. The ovarian tumor tissues were divided into four groups. The first group was the malignant ovarian epithelial tumor group; it included 31 cases with invasive surface epithelial ovarian tumors. The second group was the borderline epithelial ovarian tumor group: it included four cases with borderline intermediate malignancy. The third group was the benign epithelial ovarian tumors group: it included 18 cases with benign epithelial ovarian tumors. The fourth group had functional ovarian cystic lesions: it included eight cases with non-neoplastic functional ovarian cysts. Sections were made from each of the paraffin embedded blocks and examined using immunohistochemistry to detect HPV 16-E6-oncoprotein in ovarian tumor tissues. Results: Out of the eight cases with functional cysts only one case (12.5%) expressed HPV. No HPV expression was seen in cases with benign and borderline tumors. Out of the 31 cases with one malignant surface epithelial ovarian tumor only three (9.67%) cases expressed HPV. There was no significant statistical difference in HPV expression among neoplastic and non-neoplastic ovarian tumors included in the present study (P= 0.476). Conclusions: HPV type 16 was detected in only 9.67% of malignant epithelial tumors. It appears that HPV infection plays a relatively minor role in the pathogenesis of ovarian carcinomas.
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Affiliation(s)
- Fahem Mohsin Mahmood
- Department of Pathology, College of Medicine, Al-Nahrain University, Baghdad, Iraq
| | - Haider Sabah Kadhim
- Department of Pathology, College of Medicine, Al-Nahrain University, Baghdad, Iraq
- Corresponding author: Haider Sabah Kadhim, Medical Microbiology Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq. Tel: +96-47705336906, E-mail:
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