Chiofalo Benito, Di Giuseppe Jacopo, Alessandrini Lara, Perin Tiziana, Giorda Giorgio, Canzonieri Vincenzo, Sopracordevole Francesco
Department of Gynecologic Oncology, Centro di Riferimento Oncologico-National Cancer Institute, 33081 Aviano, Pordenone, Italy.
Department of Pathology, Centro di Riferimento Oncologico-National Cancer Institute, 33081 Aviano, Pordenone, Italy.
Pathol Res Pract. 2016 Jun;212(6):573-7. doi: 10.1016/j.prp.2016.02.025. Epub 2016 Feb 27.
Three primary synchronous cancers in the female genital tract are extremely rare. In the literature, only four studies have described three different invasive gynecologic cancers of epithelial origin identified simultaneously in the same patient.
This is the first case in the literature that reports on triple primary ovarian, endometrial and endocervical cancers in a 38-year-old woman with a history of previously treated malignant disease (acute lymphatic leukemia). With a preoperative diagnosis of endocervical adenocarcinoma stage Ib1 (according to International Federation of Gynecology and Obstetrics-FIGO), as well as an adnexal mass, she underwent radical hysterectomy with bilateral adnexectomy. Pathologic examination of the surgical specimen revealed a mucinous adenocarcinoma of the cervix, an endometrioid adenocarcinoma of the uterine corpus, and a mucinous adenocarcinoma of the left ovary. Eighteen months after appropriate treatment, the patient is free of disease.
The incidental diagnosis of more than one tumor is often a post-operative finding, usually with the detection of low-stage neoplasms. Multiple synchronous gynecologic cancers have a better prognosis than metastatic or advanced primitive disease. In a patient with multiple neoplasms, the prognosis is determined by the tumor with the worst prognosis.
女性生殖道原发性同步发生三种癌症极为罕见。在文献中,仅有四项研究描述了在同一患者中同时发现的三种不同的上皮源性侵袭性妇科癌症。
这是文献中首例报告一名38岁女性患有原发性卵巢癌、子宫内膜癌和子宫颈癌的病例,该患者既往有恶性疾病(急性淋巴细胞白血病)治疗史。术前诊断为子宫颈腺癌Ib1期(根据国际妇产科联盟-FIGO)以及附件包块,她接受了根治性子宫切除术及双侧附件切除术。手术标本的病理检查显示为宫颈黏液腺癌、子宫体子宫内膜样腺癌和左卵巢黏液腺癌。经过适当治疗18个月后,患者无疾病迹象。
偶然诊断出一种以上肿瘤通常是术后发现,通常发现的是低分期肿瘤。多种同步发生的妇科癌症比转移性或晚期原发性疾病预后更好。在患有多种肿瘤的患者中,预后由预后最差的肿瘤决定。