Samaila M O, Adesiyun A G, Oluwole O P
Department of Pathology, Ahmadu Bello University Teaching Hospital, Shika-Zaria 810001, Nigeria.
Singapore Med J. 2008 May;49(5):e139-41.
Ovarian squamous cell carcinoma is usually associated with germ cell tumours (dermoid cyst) or endometriosis in primary cancer. While tumour metastasis to the ovary is common and often bilateral in over 50 percent of cases, metastatic cervical squamous cell carcinoma to the ovary is infrequent compared to adenocarcinoma from other extraovarian primaries and the cervix. We report two cases of unilateral metastatic ovarian squamous cell carcinoma from the uterine cervix in two women aged 38 years and 48 years, respectively. They presented with abdominopelvic masses, clinically thought to be tuberculosis and primary ovarian tumour, respectively. Both had laparotomy which revealed multinodular ovarian masses with extensive extra-ovarian involvement of the corpus and uterine cervix by tumour and omental seedlings. Tissue microscopy showed total replacement of ovarian stroma by tumour with necrotic foci and containing infiltrating nests and cords of malignant squamous cells with prominent intercellular bridges. No evidence of teratoma or endometriosis was seen in the histology sections. They were both diagnosed with metastatic ovarian squamous cell carcinoma with advanced stage disease primary in the uterine cervix. Ovarian metastatic squamous cell carcinoma from the uterine cervix may occur with advanced stage cervical carcinoma. Unilateral multinodular ovarian mass with extensive extra-ovarian tumour involvement should raise suspicion of metastasis rather than of primary tumour. Early and prompt diagnosis is desirable in the management of these patients.
卵巢鳞状细胞癌通常与原发性癌症中的生殖细胞肿瘤(皮样囊肿)或子宫内膜异位症相关。虽然肿瘤转移至卵巢很常见,且在超过50%的病例中往往是双侧转移,但与来自其他卵巢外原发部位和宫颈的腺癌相比,宫颈鳞状细胞癌转移至卵巢的情况并不常见。我们报告了两例分别为38岁和48岁女性的单侧转移性卵巢鳞状细胞癌,均来自子宫颈。她们分别表现为腹盆腔肿块,临床上最初分别认为是结核病和原发性卵巢肿瘤。两人均接受了剖腹手术,术中发现卵巢有多结节肿块,肿瘤广泛累及卵巢外的宫体和子宫颈,并伴有网膜种植。组织显微镜检查显示肿瘤完全取代了卵巢间质,伴有坏死灶,包含浸润性的恶性鳞状细胞巢和条索,细胞间桥明显。组织学切片中未见畸胎瘤或子宫内膜异位症的证据。她们均被诊断为转移性卵巢鳞状细胞癌,原发于子宫颈且处于晚期。子宫颈来源的卵巢转移性鳞状细胞癌可能与晚期宫颈癌同时发生。单侧多结节卵巢肿块且伴有广泛的卵巢外肿瘤累及,应怀疑为转移而非原发性肿瘤。对于这些患者的管理,早期及时诊断是可取的。