Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital, Zekai Tahir Burak Kadin Sagligi Egitim ve Arastirma Hastanesi Cebeci, Ankara, Turkey.
Arch Gynecol Obstet. 2011 Feb;283(2):323-7. doi: 10.1007/s00404-010-1672-1. Epub 2010 Sep 18.
Although the majority of metastatic ovarian tumors arise within the female genital tract, squamous cell carcinoma of the cervix is a rare form of metastases to the bilateral ovaries by endometrial and transtubal spreading.
A 53-year-old woman was referred to the oncology clinic with postmenopausal bleeding. On vaginal examination, a 3 cm tumor arising from the cervix was inspected. Multiple cervical biopsies and endocervical curettage revealed large cell, non-keratinized squamous cell cervix carcinoma. Radical hysterectomy and bilateral salpingo-oophorectomy were performed. Bilateral pelvic and para-aortic lymph nodes were also removed. The final pathology report revealed endometrial, focal myometrial, bilateral tubal mucosal, fimbrial and bilateral ovarian squamous cell carcinoma involvement. Pelvic and para-aortic nodes were free from metastases.
Although the incidence of ovarian metastases of adenocarcinoma of the cervix is significantly higher, squamous cell carcinoma may also metastasize to the ovaries by endometrial and transtubal spreading in the absence of lymph node involvement. Especially in young patients for whom preservation of the ovaries is supposed, gross intraoperative inspection of the radical hysterectomy specimen and endometrium should be done and ovaries should be evaluated carefully.
尽管大多数卵巢转移瘤起源于女性生殖系统，但宫颈鳞癌通过子宫内膜和输卵管播散至双侧卵巢是一种罕见的转移形式。
一名 53 岁女性因绝经后出血被转至肿瘤科就诊。阴道检查发现宫颈处有一个 3 厘米大的肿瘤。多次宫颈活检和宫颈内膜刮宫术显示为大细胞非角化性宫颈鳞癌。行根治性子宫切除术和双侧输卵管卵巢切除术。还切除了双侧骨盆和腹主动脉旁淋巴结。最终的病理报告显示子宫内膜、局灶性子宫肌层、双侧输卵管黏膜、输卵管伞部和双侧卵巢的鳞状细胞癌受累。骨盆和腹主动脉旁淋巴结无转移。
尽管宫颈腺癌的卵巢转移发生率明显更高，但在无淋巴结受累的情况下，宫颈鳞癌也可能通过子宫内膜和输卵管播散转移至卵巢。特别是对于需要保留卵巢的年轻患者，应仔细检查根治性子宫切除标本和子宫内膜，并仔细评估卵巢。
