Shrivastava Sushruta, Barmon Debabrata, Deka Pankaj, Ch Kataki Amal, Choudhary Binoy Kumar
Department of Gynaecological Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
Department of Radiology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
J Midlife Health. 2014 Jan;5(1):41-4. doi: 10.4103/0976-7800.127792.
Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy of the cervix. Until date around eighteen cases of SSCC have been reported in the literature. It is an aggressive tumor with poor prognosis. The tumor usually presents at an advanced stage. Similarly, primary melanomas of the uterine cervix are rare tumors with not more than 60 cases reported in the world literature. It also has a poor prognosis. There is no reported case of sarcomatoid carcinoma with malignant melanoma. Here, we are presenting a rare case of cervical carcinoma with histopathology suggestive of SSCC with foci of malignant melanoma proven by immunohistochemistry study.
The present case report is about a 42-year-old, Mrs. SR, P5 L3 D1 A1 , presented with the complaints of intermittent bleeding per vaginum since last 3 years and severe pain in the right lower limb since 1 month. On examination, there was a proliferative growth in the cervix. Her magnetic resonance imaging (MRI) showed cervical mass lesion with right parametrial extension invading the right ureter and bladder wall causing hydroureteronephrosis with contiguous bilateral pelvic nodes. There were multiple lesions in the left femur. Diagnosis of carcinoma of cervix International Federation of Gynecology and Obstetrics stage IIIB with distant metastasis was made. Histopathology report was suggestive of sarcomatoid carcinoma with foci of melanocytic melanoma. She was planned to be treated with palliative radiation.
About 90% of cervical carcinomas are squamous cell carcinoma. Adenocarcinoma constitute about 3-4% of all cervical carcinomas. Other rare pathologies are lymphoma, melanoma, sarcoma and metastatic tumors. Our case is a rare combination of sarcomatoid carcinoma with foci of malignant melanoma of cervix.
肉瘤样鳞状细胞癌（SSCC）是一种罕见的子宫颈恶性肿瘤。迄今为止，文献中报道了约18例SSCC。它是一种侵袭性肿瘤，预后较差。该肿瘤通常在晚期出现。同样，子宫颈原发性黑色素瘤是罕见肿瘤，世界文献报道不超过60例。其预后也较差。尚无肉瘤样癌合并恶性黑色素瘤的病例报道。在此，我们报告一例罕见的子宫颈癌病例，其组织病理学提示为SSCC，免疫组化研究证实有恶性黑色素瘤灶。
本病例报告的是一位42岁的SR女士，孕5产3流1存1，因近3年来间歇性阴道出血及1个月来右下肢剧痛就诊。检查发现宫颈有增生性肿物。她的磁共振成像（MRI）显示宫颈肿物伴右侧宫旁组织受累，侵犯右侧输尿管及膀胱壁，导致肾积水及双侧盆腔淋巴结肿大。左股骨有多个病灶。诊断为国际妇产科联盟（FIGO） IIIB期宫颈癌伴远处转移。组织病理学报告提示为肉瘤样癌伴黑素细胞性黑色素瘤灶。计划对其进行姑息性放疗。
约90%的宫颈癌为鳞状细胞癌。腺癌占所有宫颈癌的3 - 4%。其他罕见病理类型为淋巴瘤、黑色素瘤、肉瘤及转移性肿瘤。我们的病例是肉瘤样癌合并子宫颈恶性黑色素瘤灶的罕见组合。
