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Sassi I, Ghalleb M, Chemlali M, Mbarek M, Charfi L, Chargui R, Rahal K. Uterine cervix metastasis from primary colon adenocarcinoma: a case report and review of the literature. J Med Case Rep 2021; 15:486. [PMID: 34598716 PMCID: PMC8487153 DOI: 10.1186/s13256-021-03055-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 08/10/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction Metastases to the female genital tract from extragenital primary tumors are unusual. We report a rare case of uterine cervix metastasis from colon adenocarcinoma and discuss diagnostic and therapeutic issues. Case report We report a case of a 38-year-old North African Caucasian woman treated for a non-metastatic colon adenocarcinoma. She had a sigmoidectomy and incomplete adjuvant chemotherapy. Six months later, she consulted with vaginal bleeding caused by a cervical tumor, which was confirmed to be metastatic disease, and the patient underwent decompressive and hemostatic radiotherapy. Conclusion Uterine cervix metastasis from primary colon adenocarcinoma is rare. The resection remains the standard protocol for the local treatment of resectable metastatic disease. Otherwise, systemic therapy is the preferable option.
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Affiliation(s)
- I Sassi
- Surgical Oncology Department, Institute Salah Azaiez de Cancer, Tunis, Tunisia.,Faculté de Medicine Tunis El Manar, Tunis, Tunisia
| | - M Ghalleb
- Surgical Oncology Department, Institute Salah Azaiez de Cancer, Tunis, Tunisia. .,Faculté de Medicine Tunis El Manar, Tunis, Tunisia.
| | - M Chemlali
- Surgical Oncology Department, Institute Salah Azaiez de Cancer, Tunis, Tunisia.,Faculté de Medicine Tunis El Manar, Tunis, Tunisia
| | - M Mbarek
- Surgical Oncology Department, Institute Salah Azaiez de Cancer, Tunis, Tunisia.,Faculté de Medicine Tunis El Manar, Tunis, Tunisia
| | - L Charfi
- Pathology Department, Institute Salah Azaiez de Cancer, Tunis, Tunisia.,Faculté de Medicine Tunis El Manar, Tunis, Tunisia
| | - R Chargui
- Surgical Oncology Department, Institute Salah Azaiez de Cancer, Tunis, Tunisia.,Faculté de Medicine Tunis El Manar, Tunis, Tunisia
| | - K Rahal
- Surgical Oncology Department, Institute Salah Azaiez de Cancer, Tunis, Tunisia.,Faculté de Medicine Tunis El Manar, Tunis, Tunisia
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2
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Secondary Involvement of the Uterine Cervix by Nongynecologic Neoplasms: A Detailed Clinicopathologic Analysis. Am J Surg Pathol 2021; 44:1699-1711. [PMID: 32910021 DOI: 10.1097/pas.0000000000001578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Secondary involvement of the uterine cervix by nongynecologic neoplasms is rare accounting for <2% of metastases to the gynecologic tract. This study aimed to analyze the clinicopathologic features of cervical involvement by nongynecologic malignancies. A total of 47 cases were identified including 39 (83%) carcinomas, 6 lymphomas (12.8%), and 2 (4.2%) cutaneous malignant melanomas. The most common primary site of origin among carcinomas was the gastrointestinal tract (27, 69.2%), followed by breast and urothelium (5 each, 12.8%), gallbladder, and lung (1 each, 2.6%). The gynecologic tract was involved at the presentation in 16 patients (34%), including 5 (10.6%) with the cervix being the first site, 7 (14.9%) with synchronous involvement of the cervix and other gynecologic sites, and 4 (8.5%) with the involvement of other gynecologic sites before the cervical presentation. Patients with lymphoma were younger compared with those with carcinoma (43.7 vs. >50.5) (P=0.01). Mean time to identification of cervical metastases was <1 year for gallbladder carcinoma, melanomas, and gastrointestinal signet ring cell carcinomas (P=0.03). Features that varied with different types of metastatic tumor included lymphovascular space invasion, depth of stromal invasion, growth pattern (glands lacking architectural complexity, cribriforming, solid), presence of goblet cells, and signet ring cells, degree of cytologic atypia, and overall findings mimicking a benign/noninvasive process (P≤0.027). Six tumors (12.8%) were initially misdiagnosed as cervical primary. Metastatic nongynecologic tumors can mimic primary in situ or invasive neoplasms in both ectocervix and endocervix. In patients with a known prior malignancy, the clinical history with ancillary studies and a high level of suspicion are crucial to ensure accurate diagnosis.
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3
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Kornfeld B, Urquhart H, Naik A. Rare case of cervical colorectal cancer metastasis. ANZ J Surg 2020; 90:2129-2131. [PMID: 32043800 DOI: 10.1111/ans.15746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Belen Kornfeld
- Department of Colorectal Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Hamish Urquhart
- Department of Colorectal Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Arun Naik
- Department of Colorectal Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
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4
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Reynolds L, Kenny S, Crozier-Shaw G, Connolly C, Joyce WP. Uterine colorectal metastatic disease: a rare occurrence. ANZ J Surg 2018; 89:963-964. [PMID: 29415367 DOI: 10.1111/ans.14402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/10/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Reynolds
- Department of Surgery, Galway Clinic, Doughiska, Ireland
| | - Sarah Kenny
- Department of Surgery, Galway Clinic, Doughiska, Ireland
| | | | | | - William P Joyce
- Department of Surgery, Galway Clinic, Doughiska, Ireland.,Royal College of Surgeons Ireland, Dublin, Ireland
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5
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Toyoshima M, Momono Y, Makino H, Kudo T, Oka N, Sakurada J, Suzuki H, Kodama H, Yoshinaga K. Cytokeratin 7-positive/cytokeratin 20-negative cecal adenocarcinoma metastatic to the uterine cervix: a case report. World J Surg Oncol 2016; 14:22. [PMID: 26810414 PMCID: PMC4727413 DOI: 10.1186/s12957-016-0774-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 01/11/2016] [Indexed: 02/07/2023] Open
Abstract
Background The vast majority of uterine cervical malignancies are primary carcinomas, and secondary neoplasms that metastasize to the uterine cervix from a distant organ are uncommon. Although relatively rare, metastases to the uterine cervix from a primary colon cancer have been reported. We report a rare case of metastatic carcinoma originating from a cecal adenocarcinoma with an unusual cytokeratin 7/cytokeratin 20 immunophenotype. Case presentation A 74-year-old postmenopausal Japanese woman was referred to our hospital for the evaluation of a uterine tumor. She had a past medical history of cecal cancer and had undergone laparoscopically assisted right hemicolectomy at the age of 69 years. During follow-up, she was found to have elevated levels of the tumor markers carbohydrate antigen 19-9 (179.7 IU/mL) and carcinoembryonic antigen (26.9 μg/L). Positron emission tomography/computed tomography showed a focus of high 18F-fluorodeoxyglucose uptake in her uterus. Examination of a cervical biopsy found a poorly differentiated adenocarcinoma that was immunopositive for cytokeratin (CK)7 and caudal-related homeobox 2 (CDX2) expression and immunonegative for cytokeratin 20 expression. The patient underwent radical hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination found invasive growth of irregular and atypical ductal hyperplasia. Immunohistochemical staining of the tumor specimen revealed the same immunophenotype as the biopsy specimen. The cecal cancer specimen from her previous surgery was also examined and found to have the same immunophenotype. The histopathological diagnosis was cecal adenocarcinoma metastatic to the uterine cervix. The patient is currently receiving adjuvant chemotherapy and to date is without evidence of recurrent disease. Conclusions Our report illustrates the importance of immunohistochemistry for the correct diagnosis of the origin of a uterine cervical adenocarcinoma in a patient with a medical history of colorectal cancer. Re-examination of a previous oncological specimen is critical for cases with a uterine lesion that is difficult to identify as primary or metastatic cancer.
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Affiliation(s)
- Masafumi Toyoshima
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, Sendai, Japan. .,Present address: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Yuta Momono
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Hiromitsu Makino
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Takako Kudo
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Naomi Oka
- Department of Pathology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Junko Sakurada
- Department of Pathology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Hiroyoshi Suzuki
- Department of Pathology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Hideaki Kodama
- Department of Surgery, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Kosuke Yoshinaga
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
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Waks AG, Lennon J, Yadav BS, Hwang H, dSchapirael Carmen M, Johnson NB, Reynolds K, Schapira L, Gilman PB, Overmoyer B. Metastasis to the Cervix Uteri 15 Years After Treatment of Lobular Carcinoma of the Breast. Semin Oncol 2015; 42:e81-94. [DOI: 10.1053/j.seminoncol.2015.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Berhili S, El Khannoussi B, Kadiri S, Mezouri I, Bazine A, Touil A, El Khiyat I, Kebdani T, Benjaafar N. Uterine cervix metastasis from a sigmoid adenocarcinoma: a rare presentation of an uncommon tumor. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2014; 1:6. [PMID: 27231559 PMCID: PMC4878055 DOI: 10.1186/2053-6844-1-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 08/26/2014] [Indexed: 11/30/2022]
Abstract
Metastatic carcinoma to the uterine cervix from colorectal cancer, through haematogenous or lymphatic spread, is extremely rare. We report the case of a 59 year old woman in whom cervical metastasis was diagnosed after 13 months of follow-up for a sigmoid adenocarcinoma, confirmed by immunohistochemical study, with a review of the literature. This case illustrates that abnormal gynecologic symptoms can reveal a disease progression on patients who suffer colorectal cancer.
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Affiliation(s)
- Soufiane Berhili
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Basma El Khannoussi
- Laboratory of Cytopathology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Selma Kadiri
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Imane Mezouri
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Amine Bazine
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Asmae Touil
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Imane El Khiyat
- Laboratory of Cytopathology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Tayeb Kebdani
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Noureddine Benjaafar
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
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8
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Uterine cervix metastasis from primary colorectal carcinoma: a report of two cases with review of literature. J Gastrointest Cancer 2012; 44:231-3. [PMID: 22961708 DOI: 10.1007/s12029-012-9437-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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9
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Pérez-Montiel D, Serrano-Olvera A, Salazar LC, Cetina-Pérez L, Candelaria M, Coronel J, Montalvo LAH, de León DC. Adenocarcinoma metastatic to the uterine cervix: a case series. J Obstet Gynaecol Res 2012; 38:541-9. [PMID: 22353422 DOI: 10.1111/j.1447-0756.2011.01747.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The objectives of this report are, first, to describe the clinical behavior of cases of carcinoma metastatic to the uterine cervix treated at our institution in order to carry out a systematic review to establish the behavioral patterns of the most frequent metastases to the cervix and, second, to generate guidelines for their diagnosis and treatment. METHODS At the National Institute of Cancer of Mexico (INCan), we performed a review of the clinical files with a diagnosis of malignant neoplasm metastatic to the uterine cervix between 1990 and 2009. For a systematic review, we conducted a PubMed search between the years 1970 and 2009 of case reports and series of cases of patients with metastatic gastric, breast, ovarian and colorectal cancer. We analyzed each report individually and extracted the patients' clinical data from our cases and reports, including the primary tumor, cervical metastases and survival rates. RESULTS There were 10 cases of tumors metastatic to the uterine cervix. Metastasis was documented in one-half of the patients during follow up, with two of these cases having the cervix as the only site. We included the following reports in the systematic review: 13 reports of gastric-associated cancer, 30 related to breast cancer, nine with ovarian-associated cancer and 10 related to colorectal cancer. CONCLUSIONS Metastatic cervical activity is an infrequent event. The prognosis of survival is poor in the presence of gastric or ovarian cancer and cervical metastases.
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Affiliation(s)
- Delia Pérez-Montiel
- Department of Pathology, National Institute of Cancer of Mexico, Mexico City, Mexico
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10
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Chereau E, Ballester M, Gonin J, Lesieur B, Darai E. Cervical Metastasis From Colorectal Cancer. World J Oncol 2011; 2:83-84. [PMID: 29147230 PMCID: PMC5649708 DOI: 10.4021/wjon304w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2011] [Indexed: 12/04/2022] Open
Abstract
Metastatic carcinoma from colorectal cancer to the uterine cervix is rare. We report a case of metastatic carcinoma from a right colon cancer to the cervix with vaginal extension 3 years after primary treatment. Our report highlights the importance of immunohistochemical analysis to determine the origin of uterine cervix cancer in the event of adenocarcinoma in a patient with a history of colorectal cancer to adapt therapeutic strategy accordingly.
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Affiliation(s)
- Elisabeth Chereau
- Department of Gynecology-Obstetrics,Tenon Hospital, Assistance Publique des Hopitaux de Paris, CancerEst, Universite Pierre et Marie Curie Paris 6, France
| | - Marcos Ballester
- Department of Gynecology-Obstetrics,Tenon Hospital, Assistance Publique des Hopitaux de Paris, CancerEst, Universite Pierre et Marie Curie Paris 6, France
| | - Julie Gonin
- Department of Pathology, Tenon Hospital, Assistance Publique des Hopitaux de Paris, CancerEst, Universite Pierre et Marie Curie Paris 6, France
| | - Benedicte Lesieur
- Department of Gynecology-Obstetrics,Tenon Hospital, Assistance Publique des Hopitaux de Paris, CancerEst, Universite Pierre et Marie Curie Paris 6, France
| | - Emile Darai
- Department of Gynecology-Obstetrics,Tenon Hospital, Assistance Publique des Hopitaux de Paris, CancerEst, Universite Pierre et Marie Curie Paris 6, France
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11
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Trastour C, Rahili A, Avallone S, Karimdjee BS, Chevallier A, Bongain A, Benchimol D. Metastasis to the uterine cervix from a rectal cancer. Eur J Obstet Gynecol Reprod Biol 2007; 130:137-8. [PMID: 16513245 DOI: 10.1016/j.ejogrb.2005.12.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Accepted: 12/22/2005] [Indexed: 10/25/2022]
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12
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Millaire M, Alobaid A, Gariépy G, Gauthier P. Metastatic Adenocarcinoma of the Cervix: A Case Report. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2005; 27:1113-6. [PMID: 16524530 DOI: 10.1016/s1701-2163(16)30394-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adenocarcinoma metastatic to the cervix is unusual. Very few cases of cervical metastases from gastrointestinal tract primary lesions have been reported in the literature, and most of them lack pathological evidence. CASE We report the case of a 75-year-old woman with a metastasis to the cervix from a large bowel adenocarcinoma that had been managed by right hemicolectomy 14 months previously. The cervical metastasis was the first sign of recurrence. CONCLUSION In women with cervical adenocarcinoma and a history of gastrointestinal or breast cancer or melanoma, specific screening should be undertaken to ensure that the cervical disease is not metastatic. The detection of adenocarcinoma in this subset of patients might be an indication of recurrent disease.
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Affiliation(s)
- Mélanie Millaire
- Département d'obstétrique-gynécologie, division d'oncologie-gynécologie, Université de Montréal, Centre hospitalier universitaire de Montréal, Montréal (Québec)
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