Abozina Alisa, Singh Naveena, Blake C
Department of Pathology and Laboratory Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, Canada (A.A., C.B.G.) Department of Cellular Pathology, Barts Health NHS Trust, London UK (N.S.).
Int J Gynecol Pathol. 2020 May;39(3):296-300. doi: 10.1097/PGP.0000000000000603.
We report a 55-yr-old woman who presented with bilateral ovarian masses, 11 yr after hysterectomy for superficially invasive stage IA1 cervical adenocarcinoma of usual (human papillomavirus-associated) type. The bilateral ovarian tumors were composed of glands lined by malignant mucinous epithelium and these tumors were metastases from her previous cervical adenocarcinoma, based on morphology, immunophenotype, and positive in situ hybridization for human papillomavirus. In addition, there was extensive involvement of the mucosa of the left fallopian tube by malignant mucinous epithelium. The patient is alive and well 2 yr after the ovarian recurrence. The phenomenon of minimally invasive cervical adenocarcinoma metastasizing to the ovary has been described previously; the extrauterine disease is typically limited to the ovaries and associated with a relatively favorable prognosis. The presence of fallopian tube involvement by cervical adenocarcinoma has rarely been reported, and suggests transtubal spread of tumor. Unique to this case is the >11 yr interval between diagnosis of the cervical and ovarian disease, with previously described cases showing up to a 7 yr latency period. This case demonstrates that spread of cervical adenocarcinoma to the ovaries, via the fallopian tube lumen, can occur after a very long latent period and this possibility must be considered when examining adnexal mass(es) in women who have previously had a hysterectomy for cervical adenocarcinoma.
我们报告了一名55岁女性，她在因常见型（与人乳头瘤病毒相关）IA1期浅表浸润性宫颈腺癌行子宫切除术后11年，出现双侧卵巢肿块。双侧卵巢肿瘤由恶性黏液上皮衬覆的腺体组成，根据形态学、免疫表型及人乳头瘤病毒原位杂交阳性结果，这些肿瘤是先前宫颈腺癌的转移灶。此外，左侧输卵管黏膜广泛被恶性黏液上皮累及。该患者在卵巢复发后2年仍存活且状况良好。微创性宫颈腺癌转移至卵巢的现象此前已有描述；子宫外疾病通常局限于卵巢，且预后相对较好。宫颈腺癌累及输卵管的情况鲜有报道，提示肿瘤经输卵管播散。该病例的独特之处在于，宫颈疾病与卵巢疾病的诊断间隔超过11年，而此前报道的病例潜伏期最长为7年。本病例表明，宫颈腺癌可经输卵管腔在很长的潜伏期后转移至卵巢，在检查既往因宫颈腺癌行子宫切除术的女性附件肿块时，必须考虑到这种可能性。
