METASTASIS OF CERVICAL CARCINOMA TO THE OVARY: A CASE REPORT
Main Article Content
Keywords
Ovaries, Metastasis, Adenocarcinoma, Cervical Cancer, Human Papillomavirus (HPV), Bilateral salpingo-oophorectomy, Pelvis paraaortic lymphadenectomy, Omentectomy Chemotherapy, Colpectomy, Brachytherapy
Abstract
Background: Human Papillomavirus (HPV) infection is the primary cause of cervical cancer. Although metastases most frequently occur through the lymphatic system to nearby organs, distant metastases, such as to the ovaries, can also arise but are less common. Prompt detection of these metastases is critical for effective treatment.
Case Presentation: We report the case of a 57-year-old female patient with a history of neoplastic disease, histologically and immunohistochemically confirmed as endocervical adenocarcinoma, stage Ib2, with ovarian metastases. The patient’s medical history includes bilateral salpingo-oophorectomy, pelvic paraaortic lymphadenectomy, and omentectomy. This study was conducted at Hayatabad Medical Complex, Peshawar, KPK Pakistan.
Clinical Course: One year post-chemotherapy, the patient presented with genital bleeding, right iliac fossa pain, and intestinal constipation. Speculum examination revealed a vegetative lesion of the vaginal fundus. Biopsy identified a well-differentiated adenocarcinoma (Grade 1). Pathological findings indicated villoglandular adenocarcinoma infiltrating the vaginal wall, necessitating a corpectomy which was performed successfully. The patient received subsequent brachytherapy and radiation treatment.
Outcome: Post-treatment colposcopic findings and oncotic cytology were within normal limits. The patient showed no signs of disease recurrence.
Conclusion: Although ovarian metastases from cervical cancer are rare, their possibility must be recognized. Prognostic evaluation should consider clinicopathological factors and imaging tests, including tumour size, lymph node status, and depth of myometrial invasion. Early detection and comprehensive treatment are essential for optimal patient outcomes.
References
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13. Chow, Z., & Fabian, D. (2024). Cervical cancer with vaginal recurrence and prior pelvic radiation. Int J Radiat Oncol Biol Phys, 118, 886-887.
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25. Li, M., & Zheng, W. (2024). Sigmoid colonic metastasis from a squamous cell carcinoma of the cervix: A rare case report with literature review. Medicine, 103(3), e37001.
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27. Macêdo, M. L., da Costa, R. E. A. R., Dos Reis, C. A., Júnior, R. G. D. S., Pires, A. O., & Vieira, S. C. (2024). Disease Progression and Death From Cervical Melanoma in a Patient Undergoing Nivolumab Therapy: A Case Report. Cureus, 16(1).
28. Meloni, P., Simari, T., Cassella, I., Roberta, L., Brizio, R., Conturso, R., . . . Tonni, G. (2024). Occult invasive cervical cancer, FIGO III stage, with a negative Pap smear test–clinical presentation and brief review of the literature: Invasive cervical cancer and negative pap smear. Česká gynekologie, 89(1).
29. Neil, A. J., Li, Y. Y., Hakam, A., Nucci, M. R., & Parra‐Herran, C. (2024). Pattern A endocervical adenocarcinomas with ovarian metastasis are indolent and molecularly distinct from destructively invasive adenocarcinomas. Histopathology, 84(2), 369-380.
30. Novikov, F. V., Anufriev, A. G., & Efremov, G. D. (2024). High-grade Serous Carcinoma Occurring in a Serous Cystadenoma on the Background of a Serous Tubal Intraepithelial Carcinoma (STIC)-like Lesion: A Case Report With Literature Review. International Journal of Gynecological Pathology, 10.1097.
31. Ogimoto, K., Kitai, M., Ota, T., Nakanishi, T., Imai, Y., Sakuma, T., . . . Yamaguchi, S. (2024). Pure primary ovarian squamous cell carcinoma with homologous recombination deficiency: a case report. European Journal of Gynaecological Oncology, 45(2).
32. Olmes, G. L., Breitbach, G. P., Tepikin, A., Nistor, A., Solomayer, E. F., & Hamoud, B. H. (2024). A metastasis of ovarian cancer in the bartholin gland: a case report with systematic literature review. Reproductive Sciences, 31(2), 550-554.
33. Otsuka, I. (2024). Peritoneal Recurrence of Squamous Cell Carcinoma in a Young Woman After Conization for Microinvasive Cervical Cancer. Cureus, 16(2).
34. Papapanagiotou, I. K., Papachatzopoulou, E., Marinopoulos, S., Koura, S., Theofanakis, C., Metaxas, G., . . . Pappa, K. (2024). Metastasis of breast cancer to the cervix: a rare entity. European Journal of Surgical Oncology, 50(2).
35. Popovic, A., Bojic, M. D., Bojic, M., Vukmirovic, F., & Juskovic, A. (2024). Cutaneous metastases of cervical cancer: a rare entity and possible mechanisms of dissemination. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 41(1), 136-138.
36. Praja, D. W., & Perbowo, P. (2024). The management of ovarian cancer in pregnancy: a rare case report. Bali Medical Journal, 13(1), 63-66.
37. Rahimi, Y., Rabizadeh, S., Seifouri, S., Seifouri, K., Salarvand, S., & Nakhjavani, M. (2024). A case report of malignant struma ovarii with papillary thyroid carcinoma. Clinical Case Reports, 12(4), e8610.
38. Salman, L., & Covens, A. (2024). Fertility Preservation in Cervical Cancer—Treatment Strategies and Indications. Current Oncology, 31(1), 296-306.
39. Shi, X., Shi, J., Li, Y., Li, X., Hu, X., & Gao, H. (2024). Primary Malignant Melanoma of the Endometrium: A Case Report. Case Reports in Oncology, 17(1), 370-376.
40. Shi, Z., Yang, L., & Bian, C. (2022). Squamous cell carcinoma in mature cystic teratoma of the ovary induced by human papillomavirus 16 infection: a case report and literature review. Medicine, 101(38), e30667.
41. Song, Y., Li, R., Wang, L., & Wang, H. (2024). Case Report: A Rare Case of Primary Angiosarcoma of the Cervix with a Literature Review. International Journal of Women's Health, 265-271.
42. Su, D., Song, X., Wu, F., Fan, S., & Li, M. (2024). Cervical clear cell carcinoma: Case report and literature review. Medicine, 103(13), e37449.
43. Sugitani, A., Ogawa, A., Yoshida, H., Kobayashi-Kato, M., Kikkawa, N., Tanase, Y., . . . Kato, T. (2024). Ovarian mesonephric-like adenocarcinoma with recurrent liver metastases: a case report with analysis of therapeutic molecular targets. International Journal of Surgical Pathology, 32(3), 578-585.
44. Thakur, S. S., Anjum, S., & Qadri, S. (2024). Malignant Struma Ovarii—Management and Follow-up of a Rare Ovarian Tumor: A Case Report. surgery, 4, 5.
45. Vias, P., Saklani, A., Singh, S., Thakur, A., & Sankhyan, E. (2024). Perinephric and Ovarian Metastasis from Advanced Urothelial Carcinoma Bladder: Case Report of a Rare Dismal Disease. Asian Pacific Journal of Cancer Care, 9(1), 207-210.
46. Wu, J., Tang, J., Luo, Y., Li, W., Liu, Y., & Xiao, L. (2024). Intraoperative implantation of 125I seeds improves prognosis in refractory stage IIIB cervical cancer: a case report and literature review. BMC Women's Health, 24(1), 153.
47. Wu, M., Zhang, W., He, L., Zhu, Y., Jiang, X., Zhang, L., . . . Li, T. (2024). High-grade serous papillary ovarian carcinoma combined with nonkeratinizing squamous cell carcinoma of the cervix: a case report. Frontiers in Oncology, 14, 1298109.
48. Zhang, Y., Zhang, X., Wang, H., & Shen, D. (2022). Stage IA1 HPV-associated cervical squamous cell carcinoma metastasizing to ovary by special pathway: a case report and literature review. Journal of Ovarian Research, 15(1), 21.
49. Zhu, R., Chen, T.-Z., Sun, M.-T., & Zhu, C.-R. (2024). Advanced cervix cancer patient with chemotherapy-induced grade IV myelosuppression achieved complete remission with cadonilimab: A case report. World Journal of Clinical Cases, 12(8), 1510.
2. Aggarwal, M., Jain, V., Garg, R., & Parihar, M. (2024). Epithelioid Trophoblastic Tumor in Hysterectomized Postmenopausal Woman: A Case Report and Review of the Literature. Indian Journal of Gynecologic Oncology, 22(2), 1-5.
3. Akers, A., Read, S., Feldman, J., Gooden, C., & English, D. P. (2024). Diagnostic challenges and individualized treatment of cervical adenocarcinoma metastases to the breast: A case report. World Journal of Clinical Cases, 12(2), 412.
4. Anjum, A. S., Maqsood, H., Younus, S., Anjum, S., & Fatima, M. (2021). A rare case of non-gestational metastatic ovarian choriocarcinoma: case report and literature review with a special emphasis on imaging. Cureus, 13(2).
5. Bianchi, T., Grassi, T., Di Martino, G., Negri, S., Trezzi, G., Fruscio, R., & Landoni, F. (2024). Low-Volume Metastases in Cervical Cancer: Does Size Matter? Cancers, 16(6), 1107.
6. Casey, L., & Singh, N. (2020). Metastases to the ovary arising from endometrial, cervical and fallopian tube cancer: recent advances. Histopathology, 76(1), 37-51.
7. Chandra, R., Kumari, S., & Sharma, D. (2024). Breast and Cervical Cancer: An Unusual Synchrony or Metachrony? Indian Journal of Gynecologic Oncology, 22(1), 29.
8. Chang, T. Y., Yeh, C.-Y., Yang, C.-Y., Lin, W.-C., Huang, C.-C., & Hung, Y.-C. (2024). Ovarian clear cell carcinoma with uterine intramural recurrence: Case report of ovarian clear cell carcinoma with fertility sparing treatment. Taiwanese Journal of Obstetrics and Gynecology, 63(1), 90-94.
9. Chen, J., Wang, T.-Y., Wu, C.-C., Hsiao, Y.-C., & Chang, C.-L. (2024). Inguinal nodal metastatic squamous cell carcinoma of unknown primary (CUP) detected 7 years before the diagnosis of vulvar squamous cell carcinoma: A case report. Taiwanese Journal of Obstetrics and Gynecology, 63(1), 85-89.
10. Chen, Q., Shen, Y., & Xie, C. (2020). Mesonephric-like adenocarcinoma of the ovary: A case report and a review of the literature. Medicine, 99(48), e23450.
11. Chen, X., Duan, H., Zhao, H., He, F., Yin, L., Liu, Y., . . . Chen, C. (2024). Perineural invasion in cervical cancer: A multicenter retrospective study. European Journal of Surgical Oncology, 50(6), 108313.
12. Chiu, H.-C., Lau, C.-H., Tan, S.-J., & Huang, S.-C. (2024). Successful pregnancy with in vitro fertilization after vaginal radical trachelectomy and pelvic lymphadenectomy in stage IB1 cervical cancer. Taiwanese Journal of Obstetrics and Gynecology, 63(1), 95-97.
13. Chow, Z., & Fabian, D. (2024). Cervical cancer with vaginal recurrence and prior pelvic radiation. Int J Radiat Oncol Biol Phys, 118, 886-887.
14. Dewan, M., Shrivastav, S., Shrivastav, B., & Singhal, A. (2024). Basaloid Squamous Cell Carcinoma Cervix: A Case Report. Indian Journal of Gynecologic Oncology, 22(1), 14.
15. El Emrani, S., Nooij, L. S., Lap, C. C., & van der Meeren, L. E. (2024). First Reported Histologically and Molecularly Confirmed Bilateral High-Grade Serous Ovarian Adenocarcinoma Metastasized to Placental Decidua of the Membranes. Pediatric and Developmental Pathology, 10935266231222180.
16. Farahani, M., Hashemi, S. A., Goodarzi, S., Hajikarimloo, B., Pour‐Ghazi, F., Noori, S., . . . Khavandegar, A. (2024). A rare case report of cervical hemangioma and a comprehensive literature review of 137 cases of cervical and uterine hemangiomas. International Journal of Gynecology & Obstetrics, 164(2), 421-435.
17. Fattorini, C., Rocca, B. J., Giusti, A., Arganini, M., Perotti, B., Cavazzana, A., . . . Volante, M. (2024). Mixed mucinous adenocarcinoma/large cell neuroendocrine carcinoma of the uterine cervix: case report and molecular characterization of a rare entity. Virchows Archiv, 484(1), 141-146.
18. Gardner, A. B., Charo, L. M., Mann, A. K., Kapp, D. S., Eskander, R. N., & Chan, J. K. (2020). Ovarian, uterine, and cervical cancer patients with distant metastases at diagnosis: most common locations and outcomes. Clinical & experimental metastasis, 37, 107-113.
19. Gashawbeza, B., Dereje, B., & Abubeker, F. A. (2024). Primary Dysgerminoma of the Uterine Cervix: A Rare Case Report. Case Reports in Obstetrics and Gynecology, 2024(1), 6465387.
20. Honda, K.-i., Miyama, M., Nishii, Y., Tasaka, R., Nakano, Y., Umesaki, N., . . . Sumi, T. (2024). Metastasis of cervical cancer indicated by elevation of serum CA125 produced by mediastinal lymph nodes: a case report. Journal of Medical Case Reports, 18(1), 112.
21. Karamooz, S., Binsol, P. D., Asirvatham, J. R., & Pargaonkar, A. (2024). Metastasis of Clear Cell Renal Cell Carcinoma to Uterine Leiomyoma: First Case Report and Review of Literature. International Journal of Surgical Pathology, 10668969241231983.
22. Kashihara, Y., Sekiyama, K., Abe, A., Yamamura, A., Kozono, Y., Okuda, A., . . . Higuchi, T. (2024). Successful fertility preservation in stage II endometrial carcinoma with long-term progestin therapy: A case report. Gynecologic Oncology Reports, 101357.
23. KIKVADZE, N., KOCHUASHVILI, N., KHMALADZE, T., GORGADZE, G., DIDAVA, G., & GABLISHVILI, M. (2024). A Case Report: Bilateral Ovarian Clear-cell Carcinoma. Junior Researchers, 2(1), 24-34.
24. Laios, A., Portela, S. D., Papadopoulou, A., Gallos, I. D., Otify, M., & Ind, T. (2021). Ovarian transposition and cervical cancer. Best Practice & Research Clinical Obstetrics & Gynaecology, 75, 37-53.
25. Li, M., & Zheng, W. (2024). Sigmoid colonic metastasis from a squamous cell carcinoma of the cervix: A rare case report with literature review. Medicine, 103(3), e37001.
26. Liu, Y., Zhang, N., & Yang, Q. (2024). Predicting the recurrence of usual-type cervical adenocarcinoma using a nomogram based on clinical and pathological factors: a retrospective observational study. Frontiers in Oncology, 14.
27. Macêdo, M. L., da Costa, R. E. A. R., Dos Reis, C. A., Júnior, R. G. D. S., Pires, A. O., & Vieira, S. C. (2024). Disease Progression and Death From Cervical Melanoma in a Patient Undergoing Nivolumab Therapy: A Case Report. Cureus, 16(1).
28. Meloni, P., Simari, T., Cassella, I., Roberta, L., Brizio, R., Conturso, R., . . . Tonni, G. (2024). Occult invasive cervical cancer, FIGO III stage, with a negative Pap smear test–clinical presentation and brief review of the literature: Invasive cervical cancer and negative pap smear. Česká gynekologie, 89(1).
29. Neil, A. J., Li, Y. Y., Hakam, A., Nucci, M. R., & Parra‐Herran, C. (2024). Pattern A endocervical adenocarcinomas with ovarian metastasis are indolent and molecularly distinct from destructively invasive adenocarcinomas. Histopathology, 84(2), 369-380.
30. Novikov, F. V., Anufriev, A. G., & Efremov, G. D. (2024). High-grade Serous Carcinoma Occurring in a Serous Cystadenoma on the Background of a Serous Tubal Intraepithelial Carcinoma (STIC)-like Lesion: A Case Report With Literature Review. International Journal of Gynecological Pathology, 10.1097.
31. Ogimoto, K., Kitai, M., Ota, T., Nakanishi, T., Imai, Y., Sakuma, T., . . . Yamaguchi, S. (2024). Pure primary ovarian squamous cell carcinoma with homologous recombination deficiency: a case report. European Journal of Gynaecological Oncology, 45(2).
32. Olmes, G. L., Breitbach, G. P., Tepikin, A., Nistor, A., Solomayer, E. F., & Hamoud, B. H. (2024). A metastasis of ovarian cancer in the bartholin gland: a case report with systematic literature review. Reproductive Sciences, 31(2), 550-554.
33. Otsuka, I. (2024). Peritoneal Recurrence of Squamous Cell Carcinoma in a Young Woman After Conization for Microinvasive Cervical Cancer. Cureus, 16(2).
34. Papapanagiotou, I. K., Papachatzopoulou, E., Marinopoulos, S., Koura, S., Theofanakis, C., Metaxas, G., . . . Pappa, K. (2024). Metastasis of breast cancer to the cervix: a rare entity. European Journal of Surgical Oncology, 50(2).
35. Popovic, A., Bojic, M. D., Bojic, M., Vukmirovic, F., & Juskovic, A. (2024). Cutaneous metastases of cervical cancer: a rare entity and possible mechanisms of dissemination. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 41(1), 136-138.
36. Praja, D. W., & Perbowo, P. (2024). The management of ovarian cancer in pregnancy: a rare case report. Bali Medical Journal, 13(1), 63-66.
37. Rahimi, Y., Rabizadeh, S., Seifouri, S., Seifouri, K., Salarvand, S., & Nakhjavani, M. (2024). A case report of malignant struma ovarii with papillary thyroid carcinoma. Clinical Case Reports, 12(4), e8610.
38. Salman, L., & Covens, A. (2024). Fertility Preservation in Cervical Cancer—Treatment Strategies and Indications. Current Oncology, 31(1), 296-306.
39. Shi, X., Shi, J., Li, Y., Li, X., Hu, X., & Gao, H. (2024). Primary Malignant Melanoma of the Endometrium: A Case Report. Case Reports in Oncology, 17(1), 370-376.
40. Shi, Z., Yang, L., & Bian, C. (2022). Squamous cell carcinoma in mature cystic teratoma of the ovary induced by human papillomavirus 16 infection: a case report and literature review. Medicine, 101(38), e30667.
41. Song, Y., Li, R., Wang, L., & Wang, H. (2024). Case Report: A Rare Case of Primary Angiosarcoma of the Cervix with a Literature Review. International Journal of Women's Health, 265-271.
42. Su, D., Song, X., Wu, F., Fan, S., & Li, M. (2024). Cervical clear cell carcinoma: Case report and literature review. Medicine, 103(13), e37449.
43. Sugitani, A., Ogawa, A., Yoshida, H., Kobayashi-Kato, M., Kikkawa, N., Tanase, Y., . . . Kato, T. (2024). Ovarian mesonephric-like adenocarcinoma with recurrent liver metastases: a case report with analysis of therapeutic molecular targets. International Journal of Surgical Pathology, 32(3), 578-585.
44. Thakur, S. S., Anjum, S., & Qadri, S. (2024). Malignant Struma Ovarii—Management and Follow-up of a Rare Ovarian Tumor: A Case Report. surgery, 4, 5.
45. Vias, P., Saklani, A., Singh, S., Thakur, A., & Sankhyan, E. (2024). Perinephric and Ovarian Metastasis from Advanced Urothelial Carcinoma Bladder: Case Report of a Rare Dismal Disease. Asian Pacific Journal of Cancer Care, 9(1), 207-210.
46. Wu, J., Tang, J., Luo, Y., Li, W., Liu, Y., & Xiao, L. (2024). Intraoperative implantation of 125I seeds improves prognosis in refractory stage IIIB cervical cancer: a case report and literature review. BMC Women's Health, 24(1), 153.
47. Wu, M., Zhang, W., He, L., Zhu, Y., Jiang, X., Zhang, L., . . . Li, T. (2024). High-grade serous papillary ovarian carcinoma combined with nonkeratinizing squamous cell carcinoma of the cervix: a case report. Frontiers in Oncology, 14, 1298109.
48. Zhang, Y., Zhang, X., Wang, H., & Shen, D. (2022). Stage IA1 HPV-associated cervical squamous cell carcinoma metastasizing to ovary by special pathway: a case report and literature review. Journal of Ovarian Research, 15(1), 21.
49. Zhu, R., Chen, T.-Z., Sun, M.-T., & Zhu, C.-R. (2024). Advanced cervix cancer patient with chemotherapy-induced grade IV myelosuppression achieved complete remission with cadonilimab: A case report. World Journal of Clinical Cases, 12(8), 1510.
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Sep 30, 2024
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Bakhtawar Abdul Jalil, Yasmeen, Syed Shahab Ud Din Shah, Mohammad Mujtaba Khokhar, & Muhammad Ahmed. (2024). METASTASIS OF CERVICAL CARCINOMA TO THE OVARY: A CASE REPORT. Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 2244-2252. https://doi.org/10.53555/2qygdm35
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Author Biographies
Bakhtawar Abdul Jalil
Department of Clinical Imaging, Women Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
Yasmeen
(a)Women Medical Officer, Women and Children Hospital Rajjar, Charsadda, KPK, Pakistan (b) Gynecology Department, Hayatabad Medical Complex, Peshawar, KPK, Pakistan
Syed Shahab Ud Din Shah
Department of Biochemistry, Quaid-I-Azam University, Islamabad, Pakistan
Mohammad Mujtaba Khokhar
Student, Shalamar Medical and Dental College, Pakistan
Muhammad Ahmed
Junior Doctor, Pakistan
How to Cite
Bakhtawar Abdul Jalil, Yasmeen, Syed Shahab Ud Din Shah, Mohammad Mujtaba Khokhar, & Muhammad Ahmed. (2024). METASTASIS OF CERVICAL CARCINOMA TO THE OVARY: A CASE REPORT. Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 2244-2252. https://doi.org/10.53555/2qygdm35