Distant Metastases in Squamous-Cell Carcinoma of the Uterine Cervix

Carlson, V. R.; Delclos, Luis; Fletcher, Gilbert H.

doi:10.1148/88.5.961

Cited by 198 publications

(147 citation statements)

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“…the rectum, followed by lymphatic spread into the regional and distant lymphatic chains (3-7). Hematogenous spread is a rare pathway of dissemination, leading to the apparition of parenchimatous lesions, with the most commonly reported being located in lungs, bones or liver (2,8). In Fagundes et al's study (8), the authors reported that the most common site of distant relapses is the lung (in 21% of cases) followed by paraaortic lymph nodes (in 11% of cases), abdominal cavity (in 8% of cases) and supraclavicular lymph nodes (in 7% of cases).…”

Section: Case Reportmentioning

confidence: 99%

“…Hematogenous spread is a rare pathway of dissemination, leading to the apparition of parenchimatous lesions, with the most commonly reported being located in lungs, bones or liver (2,8). In Fagundes et al's study (8), the authors reported that the most common site of distant relapses is the lung (in 21% of cases) followed by paraaortic lymph nodes (in 11% of cases), abdominal cavity (in 8% of cases) and supraclavicular lymph nodes (in 7% of cases). The same study demonstrated that the type of relapse is significantly influenced by the initial FIGO stage at diagnosis: patients diagnosed in early stages of the disease are more likely to develop local recurrences, while cases diagnosed in advanced stages are more likely to develop distant or distant and local recurrences; in the meantime, once the distant relapse is diagnosed, the overall survival rate is of only 12 weeks (9, 10).…”

Section: Case Reportmentioning

confidence: 99%

“…When it comes to clinical symptoms, patients with splenic metastases remain most often asymptomatic for a long period of time or present atypical complaints, such as left hypochondria pain (8). As for the rationale of associating adjuvant chemotherapy, most authors consider that it should be taken in consideration because the splenic lesion is in fact a distant metastasis necessitating systemic therapy (26,27).…”

Section: Case Reportmentioning

confidence: 99%

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Solitary Splenic Metastasis Αfter Surgically-treated Cervical Cancer – A Case Report and Literature Review

Bacalbaşa

Bălescu

Marcu

et al. 2017

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Abstract. Background Cervical cancer remains one of the most common gynecologic malignancies worldwide; although association of oncologic treatment is widely performed, a number of cases will develop, at a certain moment, distant metastases (1, 2). Unfortunately, most patients in this situation will be diagnosed with disseminated secondary lesions, being candidates only for palliative treatment. In rare cases, solitary metastases have been reported, transforming the patient into the perfect candidate for re-operation. We present the case of a 31-year-old patient diagnosed with an isolated splenic recurrence 18 months after surgically-treated cervical cancer. Case ReportWe present the case of a 31-year-old patient who initially presented to our service for pelvic pain and massive vaginal bleeding. At that moment, a cervical biopsy revealed the presence of a moderately differentiated squamous cell cervical cancer. The preoperative investigations revealed a stage IIB cervical tumor, so the patient was submitted to neoadjuvant chemotherapy and radiation therapy followed by surgery; a total radical hysterectomy en bloc, with bilateral adnexectomy and pelvic lymph node dissection was performed. The histopathological studies confirmed the presence of an area of 5 mm with 4-mm deep invasion with malignant transformation; in the meantime, the histopathological evaluation of the lymph nodes revealed the absence of tumoral invasion in none of the retrieved lymph nodes (eleven left side lymph nodes and seven right side lymph nodes). These findings classified the lesion as a T1a2, pN0, M0 cervical cancer. At 18 months follow-up, the patient was diagnosed with an isolated tumoral mass of 5/5 cm located in the splenic hylum, so the patient was re-operated. Intraoperatively, the diagnostic of solitary splenic lesion was confirmed, so the patient was submitted to splenectomy (Figures 1-5). The postoperative course was uneventful, with the patient being discharged in the fifth postoperative day. The histopathological study revealed the presence of a 5/5 cm lesion with a typical aspect of a splenic metastasis of a moderately differentiated squamous cell cervical cancer. One month after discharge, the patient was submitted to adjuvant chemotherapy consisting of six cycles of cisplatin and paclitaxel. At one year follow-up, the patient is free of any recurrent disease or distant metastases. DiscussionCervical cancer has a high propensity of local spread, after destroying the natural compartmental borders, leading to the apparition of pelvic masses involving the urinary bladder and/or 2615

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Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Solitary Splenic Metastasis Αfter Surgically-treated Cervical Cancer – A Case Report and Literature Review

Bacalbaşa

Bălescu

Marcu

et al. 2017

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“…[12][13][14] The response rates to Cytoxan and Adriamycin are reported to be 65% and 16-40%, respectively. 15,16 This confirms that surgical treatment with complete resection of metastasis, is the best form of treatment. Fuller et al, report that longer EFD (> 36 months) is associated with good prognosis.…”

Section: Discussionmentioning

confidence: 54%

Pulmonary resection for isolated pulmonary metastasis: patterns of disease

2017

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Background: Pulmonary metastasectomy dates back to 1880s, sub lobar resections, lobectomy and pneumonectomy, described in the setting of metastatic sarcoma, renal cell cancer, testicular NSGCT. Extremity sarcoma is the most common primary site for metastasis to lung. Almost 20 % of patients with extremity sarcoma, give rise to isolated pulmonary metastasis at some point in the course of the disease. Though pulmonary metastasis commonly arises from primary tumors in extremities, they may arise from any histologic variant. Despite progresses in multimodality treatment, there are significant deaths, after metastasis from soft tissue malignancies. There is evidence that surgical resection is the treatment of choice for isolated pulmonary metastasis from extremity sarcoma. Chemotherapy has proved to be ineffective to increase survival in such cases. Keeping this in mind we report an analysis of 11 such cases in terms of patterns of disease, for Isolated pulmonary metastasis originating from various histologic variants. Methods: This is a retrospective study from July 2006 to September 2016, carried out at NKP Salve Institute of Medical Sciences. During this period, total 13 patients were admitted with Isolated pulmonary metastasis. Out of 13 patients 2 patients were later on proved to have metastasis in the liver and so excluded from study. Of 11 patients, metastasis from soft tissue sarcoma of extremity were (5), cancer of uterine cervix (3), non seminomatous germ cell tumor of testis (3). All 11 patients were treated with pulmonary resectional surgery. Patterns of disease in terms of specific survival from various histological variants. Results: The median survival for soft tissue sarcoma from the diagnosis of pulmonary metastasis for all 5 patients was 18 to 26 months. Reports suggest, with non-operative therapy for soft tissue sarcoma, the median survival was 11 months. After pulmonary mastectomy, three-year survival for these patients was around 23%. For world wide data suggest the prevalence of pulmonary metastasectomy was 3.6% in cancer cervix. In the present study, the mean disease-free duration for cancer cervix after pulmonary resection was more than 60 months. In the present study, all 3 patients are still alive even after 5 years with no recurring disease. Reports published in 2016 surgical clinics show 5-year survival in 80%. Patients with NSGCT showed persistent rising levels of (ß HCG, ae fetoprotein, LDH) and CT evidence of active pulmonary metastasis, with 4 or less nodules were subjected for surgery, with outcome of 2 patients had recurrent disease died at the end of 27 th month. 1 patient is still alive after 11 years. Patients with complete resection of all metastatic disease was the important prognostic factor for survival. Conclusions: Isolated pulmonary metastasis is not a very common disease in this part of the world. Complete surgical resection of metastasis is the single most important factor which determines outcome in these patients. Disease free interval (DFI), number of metastati...

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“…7 About 15% of uterine cervical cancer patients experience distant metastases, which may be synchronous or metachronous. 9 The average interval of EBM to occur after the diagnosis of primary uterine cervical cancer is 5.4 years. 10,11,12 In two cases reported by Yonsei et al, the interval was 3 and 2.2 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

Metachronous endobronchial metastasis from uterine cervical adenocarcinoma

Darling

2018

S. Afr. j. oncol.

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Malignant involvement of the lung can be primary or metastatic. Although primary lung cancer may be endobronchial, parenchymal or both, metastases to the lung are generally parenchymal. However, less commonly, they may be endobronchial. The lungs are the most common site of metastases among all the malignancies. Common extrapulmonary malignancies causing endobronchial metastases (EBMs) are breast, colorectal and kidney. EBMs from uterine cervical cancer are very rare. Although there are a few case reports in the medical literature describing EBM from cervical cancer, none are from adenocarcinoma histology. In this study, we report a case of EBM which on histopathological examination and immunohistochemistry were found to be from a prior adenocarcinoma cervix. Differentiating EBM from bronchogenic carcinoma and other more common extrapulmonary solid organ malignancies may present a clinico-pathological and radiological challenge.

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Distant Metastases in Squamous-Cell Carcinoma of the Uterine Cervix

Cited by 198 publications

References 2 publications

Solitary Splenic Metastasis Αfter Surgically-treated Cervical Cancer – A Case Report and Literature Review

Solitary Splenic Metastasis Αfter Surgically-treated Cervical Cancer – A Case Report and Literature Review

Pulmonary resection for isolated pulmonary metastasis: patterns of disease

Metachronous endobronchial metastasis from uterine cervical adenocarcinoma

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