Leptomeningeal metastasis of uterine cervical cancer 17 years after primary tumor treatment

Oike, Takahiro; Ohno, Tatsuya; Noda, Shin‐ei; Murata, Tomomi; Hirakawa, Takashi; Hirato, Junko; Furuya, Masako; Sato, Hiro; Hirota, Yuka; Minegishi, Takashi; Nakano, Takashi

doi:10.1002/ccr3.445

Cited by 4 publications

(8 citation statements)

References 17 publications

(26 reference statements)

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“…[ 8 ] Oike et al reported that metastasis to the leptomeninges from the uterine cervix after several times radiotherapy to different metastatic vertebral bones with relative high dose (40 Gy in 20 fractions followed by stereotactic body radiotherapy 30 Gy in 10 fractions). [ 3 ] Interestingly, LM occurred in our patient after reirradiation to vertebral bone, indicating that reirradiation to the same area or irradiation with high dose increases the risk of damage to the blood-spinal cord barrier (BSCB), which in turn increases the likelihood of cancer cells to pass through the BSCB to the meninges.…”

Section: Discussionmentioning

confidence: 91%

“…To the best of our knowledge, only 19 cases of this disease have been reported in the English-language literature and only 2 cases have involved adenosquamous carcinoma. Of those two, one was FIGO stage IVB [ 3 , 4 ] and the other was IB2. [ 1 ] After primary treatment for carcinoma of the cervix, the interval to detection of the meningeal metastases was 0 months in the patient with stage IVB disease and 57 months in the patient with stage IB2 disease.…”

Section: Discussionmentioning

confidence: 99%

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Leptomeningeal metastasis of poorly differentiated uterine cervical adenosquamous carcinoma following reirradiation to metastatic vertebrae

Lu¹,

Fong

et al. 2017

Medicine

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Rationale:Leptomeningeal metastasis from cervical adenosquamous carcinoma is extremely rare especially after radiotherapy for vertebral metastasis.Patient concerns:A 52-year-old woman with International Federation of Gynecology and Obstetrics (FIGO) stage IIB adenosquamous carcinoma of cervix presented with bilateral lower limbs weakening after 2 courses radiotherapy to thoracic vertebral metastases.Diagnoses:Initial spine magnetic resonance imaging (MRI) showed no obvious nerve compression, and radiation myelopathy was suspected by the clinician. Progressive multifocal neurological signs developed one month after completion of spine re-irradiation. She was diagnosed with leptomeningeal metastasis by MRI and cerebrospinal fluid (CSF) study.Interventions:She received whole brain irradiation with a dose of 30 Gy in 10 fractions. Systemic chemotherapy with cisplatin (50 mg/m2) and topotecan (0.75 mg/m2) was administered sequentially.Outcomes:She died with progressive disease two months after the diagnosis of leptomeningeal metastases.Lessons:Poorly differentiated advanced-stage cervical adenosquamous carcinoma is an aggressive neoplasm with a worse outcome. Leptomeningeal metastasis should be included in the differential diagnosis for patients with multifocal craniospinal neurological signs. A combination of detailed neurological examinations, MRI and CSF study allowed us to establish a correct diagnosis of leptomeningeal metastasis and initiate treatment in a timely manner.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Leptomeningeal metastasis of poorly differentiated uterine cervical adenosquamous carcinoma following reirradiation to metastatic vertebrae

Lu¹,

Fong

et al. 2017

Medicine

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“…A total of 26 reported cases of LM from cervical cancer, including our two cases (Table 1). 2,4,6–23 The age at the initial visit was 30–64 years, with a median age of 47 years. LM from cervical cancer includes all histological subtypes: 15 cases with SCC (58% of all cases), 4 cases with adenocarcinoma (15%), 3 cases with adenosquamous carcinoma (12%), and 4 cases with neuroendocrine cancer (NEC) (15%).…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, LM from cervical carcinoma is extremely rare with only 24 cases reported in the English‐language literature 4,6–12 . Here we present two cases and review previously reported cases.…”

Section: Introductionmentioning

confidence: 85%

Leptomeningeal metastasis from cervical cancer: Report of two cases and a review of the literature

Omori

Ogawa

Oyama

et al. 2021

J of Obstet and Gynaecol

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Leptomeningeal metastases from cervical cancer are extremely rare, with only 24 cases reported in the English‐language literature. Leptomeningeal metastasis (LM) is usually a late event, but it can develop at any stage. A 44‐year‐old woman presented with vertigo, tinnitus, diminution of hearing, and a cervical tumor at the initial visit. She underwent whole brain radiotherapy and systemic chemotherapy. Five months after the initial visit, her condition deteriorated rapidly and she died. A 49‐year‐old woman underwent surgery and pelvic radiotherapy for cervical cancer. She underwent resection of lung metastases 2 years later and received systemic chemotherapy for lymph node metastases 4 years later. Five years after the initial visit, the patient suddenly presented with diplopia, headache, and vomiting; her clinical course was fulminant and she died. Most patients with LM present with diverse clinical manifestations and deteriorate rapidly despite multiple treatment modalities. Gynecologic oncologists should be aware of this rare complication.

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“…Leptomeningeal metastases from solid tumors most commonly arise from breast and lung cancers and melanoma. Genitourinary cancers (including ovarian, prostate, bladder, kidney and cervical), however, rarely cause LM; in the experience of the MD Anderson Cancer Center over more than 30 years, the reported incidence of LM caused by metastatic spread of cervical carcinoma was 0.03% (4/13,289) only [ 7 ], confirmed also by literature reviews [ 8 , 9 ]. Poorly differentiated squamous cell and neuroendocrine carcinomas are the most common histologic subtypes of cervical cancer associated with LM [ 9 ].…”

Section: Introductionmentioning

confidence: 98%

Leptomeningeal Carcinomatosis of a Poorly Differentiated Cervical Carcinoma Caused by Human Papillomavirus Type 18

Zorzato

Zambon

Gori

et al. 2021

Viruses

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Cervical cancer is caused by a persistent infection with high-risk types of Papillomaviruses (hrHPV); HPV16 and HPV18 are associated with about 70% of the cases. In the last decades the introduction of a cervical cancer screening has allowed a decrease in cervical cancer incidence and mortality; regular adhesion to the screening procedures, by pap test or HPV test, and colposcopy, according to the international guidelines, prevents cancer development and allows for diagnosis at the early stages. Nowadays, in industrialized countries, it is not common to diagnose this pathology in advanced stages, and this occurrence is frequently associated with patient’s unattendance of cervical screening programs. We describe a case of delayed diagnosis of cervical cancer, posed only after the onset of the neurological symptoms caused by leptomeningeal metastases, despite a two-year history of abnormal cytology. The endocervical mass was analyzed by immunohistochemistry, and search and typing of HPV sequences was performed by PCR in the meningeal carcinomatous cells. A poorly differentiated squamous cell carcinoma was diagnosed, and HPV18 sequences were detected. This rapidly fatal case highlights the importance of following the evidence-based recommended protocols and the preventive role of the population-based cervical cancer screening programs.

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Leptomeningeal metastasis of uterine cervical cancer 17 years after primary tumor treatment

Cited by 4 publications

References 17 publications

Leptomeningeal metastasis of poorly differentiated uterine cervical adenosquamous carcinoma following reirradiation to metastatic vertebrae

Leptomeningeal metastasis of poorly differentiated uterine cervical adenosquamous carcinoma following reirradiation to metastatic vertebrae

Leptomeningeal metastasis from cervical cancer: Report of two cases and a review of the literature

Leptomeningeal Carcinomatosis of a Poorly Differentiated Cervical Carcinoma Caused by Human Papillomavirus Type 18

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