Tseng M J, Ho K C, Lin G, Yen T C, Tsai C S, Lai C H
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Eur J Gynaecol Oncol. 2007;28(3):225-8.
Peritoneal metastasis presenting at initial diagnosis of squamous carcinoma of the uterine cervix is extremely rare. However, one such case was treated successfully with curative treatment.
A 43-year-old woman presented with FIGO Stage IVA cervical carcinoma and underwent concurrent chemoradiation (CCRT) with weekly cisplatin. During CCRT, she suffered from acute lower abdominal pain, high fever, and leukocytosis. Computed tomography (CT) favored a tubo-ovarian abscess, while [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) showed a lesion midway between the umbilicus and symphysis pubis. An exploration by laparoscopy, an omental metastasis adhering to the bladder dome was excised. This patient finished CCRT encompassing the disease extent including the trochar sites and no evidence of disease was noted 50 months after initial diagnosis.
Though peritoneal metastasis above the pelvis seems ominous, curative treatment may still be viable in selected patients, even in surgical Stage IVB.
子宫颈鳞状癌初诊时出现腹膜转移极为罕见。然而,有一例此类病例经根治性治疗后获得成功。
一名43岁女性,诊断为国际妇产科联盟(FIGO)IVA期宫颈癌,接受每周一次顺铂同步放化疗(CCRT)。在CCRT期间,她出现急性下腹痛、高热和白细胞增多。计算机断层扫描(CT)显示倾向于输卵管卵巢脓肿,而[18F]氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)显示脐与耻骨联合之间有一病灶。通过腹腔镜检查进行探查,切除了附着于膀胱穹窿的网膜转移灶。该患者完成了包括穿刺部位在内的疾病范围的CCRT,初诊50个月后未发现疾病迹象。
尽管盆腔以上的腹膜转移似乎预后不佳,但即使在手术IVB期,对部分患者进行根治性治疗仍可能可行。