Pulmonary metastasis from carcinoma of the uterine cervix

Of 817 patients with carcinoma of the uterine cervix that were treated and followed-up, 50 (6.1%) developed pulmonary metastases. The incidence of pulmonary metastasis was 3.2% in stage I, 5.0% in stage II, 9.4% in stage III, and 20.9% in stage IV disease. The incidence of pulmonary metastasis in patients with adenocarcinoma and undifferentiated carcinoma was higher. Of the patients in whom lung metastases were detected, 41.7% had no symptoms; 96% was diagnosed within 2 years from the initiation of treatment. All patients had abnormal shadows in chest X rays. We recommend that chest X rays be obtained every 2 months within the 8 months after treatment and every 6 months thereafter. Eighty-one percent of the patients had local recurrence or other distant metastatic lesions. The main treatment for these patients was chemotherapy, and CAP was effective for the patients with adenocarcinoma. Surgical resection of the pulmonary lesion may be an effective treatment for the patients who have no lesions in other sites.     

Ovarian metastasis in carcinoma of the uterine cervix

BACKGROUND: The present study was conducted to determine the frequency and clinicopathological features of ovarian metastasis in a large population of patients with stage Ib-IIb cervical cancer. METHODS: The study population consisted of 3471 patients with stage Ib to IIb cervical cancer who underwent radical hysterectomy, including pelvic lymphadenectomy and bilateral salpingo-oophorectomy, at our six institutions between 1981 and 2000. To our knowledge, this study is the largest review of patients with ovarian metastasis from cervical cancer. We reviewed the patients' medical records to determine clinicopathological features. RESULTS: Fifty-two patients (1.50%) had ovarian metastases: 6 in stage Ib1, 12 in stage Ib2, 5 in stage IIa, and 29 in stage IIb. The mean age of patients with ovarian metastasis was 49.9 years (range: 29-73 years). The incidence of ovarian metastasis in patients with cervical cancer was 0.22% for stage Ib, 0.75% for stage IIa, and 2.17% for stage IIb with squamous cell carcinoma, and 3.72%, 5.26%, and 9.85%, respectively, in adenocarcinoma. Ovarian metastasis occurred more frequently among patients with adenocarcinoma than among those with squamous cell carcinoma (5.31% vs. 0.79%). Outcome for patients with ovarian metastasis was very poor and not related to FIGO stage and histological type. The presence of ovarian metastasis did not correlate with lymph node involvement or parametrial invasion. CONCLUSION: Study results indicate that ovaries can be preserved in patients with stage Ib-IIa squamous cell carcinoma but removed in all patients with adenocarcinoma.     

Surgical treatment for neuroendocrine carcinoma of the uterine cervix.

OBJECTIVE: To identify the best operative approach for neuroendocrine cervical carcinoma (NECC). METHODS: The records of surgically treated patients with stages IB to IIB NECC were reviewed. RESULTS: Of 10 patients who met the study criteria for NECC and underwent radical hysterectomy, 4 had pT1bN0, 4 had pT1bN1, 1 had pT2aN0, and 1 had pT2bN1 disease. Those with pT1bN1 or pT2bN1 disease received postoperative adjuvant radiotherapy and/or chemotherapy, and recurrence occurred in 7 patients (70%). Among these 7 patients, 5 (71%) had a primary NECC tumor with deep stromal invasion and 5 (71%) had extrauterine disease (parametrium and/or lymph node). The recurrences in 6 patients (86%) were located outside the pelvis (lung, liver, or brain). Stromal invasion was 6 mm or less in the 3 patients who did not experience disease recurrence. CONCLUSIONS: Pelvic control by radical hysterectomy may not be beneficial for patients with NECC except for those with an early invasive lesion.     

Surgical therapy of the uterine cervix carcinoma in Ib2 stage

Carcinoma of the uterine cervix is from many years the most common neoplasm of the female minor pelvic. In case of Ib2 stage there is no concrete, optimal way of therapy. The aim of the study was to compare the ways of surgical therapy of cervical carcinoma in Ib1 and Ib2 stages. The operative and postoperative history of 63 women with diagnosed planoepithelial carcinoma of the cervix in the Ib stage was analyzed. In each case the radical hysterectomy class III after Rutledge was performed. The division on the Ib1 and Ib2 stages was performed on the base of histopathological qualification of the size of the tumor. The 2 examined group were distinguished: the 1-st-42 cases of cervical carcinoma in Ib1 stage and the 2-nd-21 cases of Ib2 staged carcinoma. The radically of the operations intra- and postoperative complications in both of the groups were compared. The results were analyzed by the Chi 2 and t tests. The medium age of the women with cervical carcinoma, in Ib1 stage was 47.3 years (the range between 32 and 52 years), the medium age the women with carcinoma in Ib2 stage was 46.6 years (the range between 39 and 59 years). On the base of analysis performed there was no statistically significant differences in radicality, medial account of lymphatic nodes removed and incidence of complications of radical hysterectomy with pelvic lymphadenectomy in case of cervical carcinoma in Ib1 and Ib2 stages detected.     

Femur metastasis in carcinoma of the uterine cervix: a rare entity

Purpose  

We report the first case of isolated femur metastasis in a locally advanced cervical cancer (LACC) patients.     

Late metastasis of a breast carcinoma to the uterine corpus and cervix]

In a 55-years-old woman 11 years after radical operation of a left-sided breast cancer a late metastasis in the uterine corpus was diagnosed and treated by subtotal hysterectomy. In the further course a carcinoma developed in the opposite breast, which may be most probably a second primary breast cancer. However a contralateral metastasis of the earlier treated breast cancer cannot certainly be excluded. Finally, a metastasis of the left sided-breast cancer was diagnosed in the uterine cervix. This case shows, that gynaecological bleedings also may be caused by atypical metastasis of a breast cancer.     

Radiotherapeutic management in carcinoma of the uterine cervix: current status

Despite refinement in the delivery of external radiation and brachytherapy, there has been little improvement in the survival rate of patients with invasive cancer of the uterine cervix in recent years. With advancing stage disease, there is an increase in both local failure and distant metastases. Although recent efforts to improve local control for late stage disease have been encouraging, research efforts should be directed to the identification of new active drugs for radiation sensitization and systemic therapy. Also, due to early detection, therapeutic investigations should focus on the high-risk subsets of patients with early stage disease.     

Oral cavity metastasis from carcinoma of the cervix.

A case report of a patient with carcinoma of the cervix with metastasis to the oral cavity clinically mimicking a primary oral cavity neoplasm is described. The patient presented one year after completing radiotherapy followed by radical hysterectomy and pelvic lymphadenectomy for carcinoma of the cervix. Excellent palliation was produced with radiotherapy. We are not aware of any reported case of oral cavity metastasis from carcinoma of the cervix.     

Scalp metastasis from squamous cell carcinoma of the cervix

Abstract. Maheshwari GK, Baboo HA, Ashwathkumar R, Dave KS, Wadhwa MK. Scalp metastasis from squamous cell carcinoma of the cervix.
We describe a 45-year-old woman with squamous cell carcinoma of the cervix stage IIB, who was initially treated with radical radiotherapy. The patient developed multiple scalp metastases 8 months following her treatment. The scalp was involved in the disease as the sole anatomic site of distant cutaneous metastasis. The scalp lesions were treated with palliative radiotherapy. A search of the literature revealed only two cases of such distant metastatic involvement of the scalp from cervical cancer.     

Lymphoepithelioma-like carcinoma of the uterine cervix

A 36-year-old woman presented unwell, with abdominal pain. A pelvic mass was found and being investigated but when she deteriorated and became peritonitic. An emergency laparotomy was performed and she required a pelvic clearance for a Stage IIB ovarian tumour, later confirmed as a yolk sac tumour. Accurate staging and tumour-reductive surgery strongly affects the prognosis of yolk sac tumours. Thus ability to perform a meticulous surgical clearance may well positively impact on the outcome for these young patients. This case describes the challenges that generalists will be faced with when highly suspicious cancer patients present as an emergency.     

Verrucous carcinoma of the uterine cervix

Three cases of verrucous carcinoma arising at the uterine cervix were presented with regard to their clinical courses, histological and ultrastructural findings, referring specially to the problems of diagnosis and treatment, and the relationship between viral infection and the disease. In order to obtain a correct diagnosis of verrucous carcinoma, not only repeated punch biopsies, but also wide resection of the tumor by incision biopsy are indispensable, aiming at an accordance between clinical and pathological diagnosis. In treating verrucous carcinoma, which is a slowly progressive nonmetastasizing tumor with strong local invasion, surgery should be the primary choice. Radiotherapy including postoperative irradiation is contraindicated for the reason that not only is verrucous carcinoma radioresistant, but also because anaplastic change following radiation often occurs. Even though in our survey using electronmicroscopy, no virus-like particles were observed, there still remains a strong possibility of the participation of some infections in verrucous carcinoma. This is because all of the primary lesions in our cases, like the other reports in the literature, were located at the posterior lip of the portio .     

Adenocarcinoma of the uterine cervix with choriocarcinomatous metastasis

BACKGROUND: Nongestational choriocarcinoma, in very rare instances, has been described as a component of other malignancies with a tendency for a very poor prognosis. CASE: A 55 year old woman was diagnosed with adenocarcinoma of the cervix, and incompletely treated with only external beam radiation. Adjuvant radical hysterectomy demonstrated no residual tumor, but the patient developed a tumor metastasis mimicking a pulmonary artery thrombus which by histology and immunohistochemistry was pure choriocarcinoma. While chemotherapy was successful in achieving a complete remission, the patient succumbed to complications of her pulmonary metastasis. CONCLUSION: Choriocarcinomatous dedifferentiation of cervical adenocarcinoma is extremely rare, with only one other case reported in the literature. While the prognosis for patients with such a tumor is generally poor, aggressive combination chemotherapy may be of benefit in some.