Gasparri Maria Luisa, Bellati Filippo, Pernice Milena, Di Donato Violante, Morano Giuseppina, Marchetti Claudia, Donfrancesco Cristina, Antonilli Morena, Benedetti Panici Pierluigi
Tumori. 2014 Mar-Apr;100(2):e52-4. doi: 10.1177/030089161410000225.
Recurrent cervical cancer has traditionally been associated with a dismal prognosis. Historically, patients who developed distant metastases from cervical cancer were not considered eligible for surgical resection; only palliative treatment options are available, generally consisting of chemo- and/or radiotherapy. Metastases usually appear in the liver, lung or lymph nodes. The abdominal cavity is a quite unusual site of recurrence and the disease usually has multiple foci. For this reason, peritoneal involvement by cervical cancer is considered a contraindication to local treatment.
We report the first case of a 30-year-old woman with isolated intra-abdominal cervical cancer recurrence diagnosed with 18F-FDG PET/CT, successfully surgically treated.
Histopathological analysis confirmed the tumor to be an omental relapse of squamous cervical cancer previously treated with anterior pelvic exenteration and platinum based chemotherapy. The patient underwent adjuvant treatment with 3 cycles of topotecan and has remained free of disease during the 4 years of follow-up.
In selected cases with isolated recurrences, a surgical resection may provide a long term complete remission in recurrent cervical cancer patients.
复发性宫颈癌传统上预后不佳。历史上,宫颈癌发生远处转移的患者不被认为适合手术切除;只有姑息性治疗选择,通常包括化疗和/或放疗。转移通常出现在肝脏、肺或淋巴结。腹腔是一个非常不寻常的复发部位,且疾病通常有多个病灶。因此,宫颈癌累及腹膜被视为局部治疗的禁忌证。
我们报告首例通过18F-FDG PET/CT诊断为孤立性腹腔内宫颈癌复发的30岁女性患者,其成功接受了手术治疗。
组织病理学分析证实肿瘤为先前接受前盆腔脏器清除术和铂类化疗的宫颈鳞状癌网膜复发。该患者接受了3个周期拓扑替康的辅助治疗,在4年随访期间无疾病复发。
在某些孤立复发的病例中,手术切除可能使复发性宫颈癌患者获得长期完全缓解。