Gallardo-Alvarado Lenny, Ramos Alma Astorga, Perez-Montiel Delia, Ramirez-Morales Rebeca, Diaz Erick, Leon David Cantu-de
Department of Clinical Research, National Cancer Institute.
Medical Oncology Department, Mexican Institute of Social Security, Coahuila.
Medicine (Baltimore). 2020 Jul 2;99(27):e20897. doi: 10.1097/MD.0000000000020897.
Acrometastasis is infrequent and generally indicates a wider spread of metastasis with poor prognosis. The diagnosis is challenging, as it might mimic an infectious, inflammatory, or metabolic disease. Acrometastasis are most commonly found in patients with lung, gastrointestinal, kidney, and breast cancer. Only 3 cases of cervical cancer associated with hand metastasis have been reported in the literature.
Herein, we report a 58-year-old patient with locally advanced cervical cancer and recurrence in the right thumb as presentation of widespread disseminated disease. She initially presented with adenocarcinoma of the uterine cervix and was treated with concurrent chemoradiation followed by high-dose rate brachytherapy. Six months later, she developed an insidious onset of pain and swelling in the right thumb, erythema, and edema, mimicking cellulitis.
A biopsy of the soft tissues of the thumb was performed, and the histopathology indicated metastasis of adenocarcinoma to the bone and soft tissues.
The patient rejected further treatment and died of progressive disease 4 months after the diagnosis of the recurrence.
Metastases in unusual sites are a diagnostic challenge, and there is no standardized treatment. Timely diagnosis and treatment can improve the prognosis of these patients and might preserve their quality of life.
肢端转移并不常见,通常提示转移范围更广且预后较差。其诊断具有挑战性,因为它可能类似感染性、炎症性或代谢性疾病。肢端转移最常见于肺癌、胃肠道癌、肾癌和乳腺癌患者。文献中仅报道了3例与手部转移相关的宫颈癌病例。
在此,我们报告一名58岁的患者,患有局部晚期宫颈癌,以右拇指复发作为广泛播散性疾病的表现。她最初表现为子宫颈腺癌,接受了同步放化疗,随后进行了高剂量率近距离放疗。6个月后,她右拇指出现隐匿性疼痛、肿胀、红斑和水肿,类似蜂窝织炎。
对拇指软组织进行了活检,组织病理学显示腺癌转移至骨骼和软组织。
患者拒绝进一步治疗,在复发诊断后4个月死于疾病进展。
不常见部位的转移是一个诊断难题,且没有标准化治疗方法。及时诊断和治疗可改善这些患者的预后,并可能维持其生活质量。