Introduction Cervical cancer is the fourth most common cancer among females. Squamous cell carcinoma is the most common subtype of cervical cancer, followed by adenocarcinoma. The most reported sites of metastasis are the lungs, bones, liver, and brain. One of the rarest sites of metastasis, particularly from the adenocarcinoma subtype, is the spleen, with only four reported cases in the literature. Case report A 54-year-old post-menopausal female was diagnosed with adenocarcinoma of the endocervix (FIGO stage IIIB) after she presented to the gynecologist complaining of post-coital vaginal bleeding. The patient received chemoradiotherapy followed by brachytherapy. After completion of treatment, she had a restaging work-up which revealed a complete radiological and pathological response. During her routine follow-up, she was found to have a new splenic lesion by surveillance abdominopelvic MRI three years after completion of treatment. Surgical resection was performed, and pathological analysis confirmed the diagnosis of metastatic cervical adenocarcinoma to spleen. Conclusion Cervical cancer metastasis to spleen is very rare, especially in the cervical adenocarcinoma subtype. A high index of suspicion is necessary during follow-up. Once there is a suspicion of splenic metastasis, surgical intervention should be considered for both curative and palliative intents.
Peripheral arterial disease (PAD) is a common disease with multiple risk factors and affects patients worldwide. Several international studies have established correlations between anatomical topography/distribution of atherosclerosis and comorbidities in patients with PAD. In this cohort study, we aimed to analyze the patterns of atherosclerosis (site, distribution, and degree) in patients who underwent lower limb computed tomography angiography and arterial angiography by identifying the atherosclerotic plaque(s) that were possibly responsible for thrombi. Additionally, we aimed to determine any relationship between comorbidities and identified patterns. Patients and Methods: Between January 2015 and January 2021, we retrospectively recruited 140 patients at King Fahd Hospital of the University of Saudi Arabia. Data collected included patient characteristics, risk factors, and metabolic disorders, such as hypertension (HTN), diabetes mellitus (DM), dyslipidemia, and chronic kidney disease. Patients with incomplete records or unavailable radiological images were excluded. Results: The infrapopliteal territory was the most common segment that was affected. HTN, DM, and dyslipidemia were found in 81.4%, 77.9%, and 62.9% of patients, respectively. Correlation analyses revealed that DM was the only independent metabolic disorder associated with a PAD distribution pattern in the femoropopliteal segment (p=0.039), thus denoting distal involvement. No significant association was found between PAD distribution and the severity of stenosis. Conclusion: Segmental involvement in PAD varies with the risk factors and metabolic comorbidities present in patients. DM is an independent predictor of the anatomical distribution of PAD. The identification of such an anatomical distribution is paramount for screening procedures, early detection of disease, and prevention of complications, particularly limb amputation.
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