Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
Clin J Gastroenterol. 2022 Apr;15(2):441-445. doi: 10.1007/s12328-022-01603-x. Epub 2022 Feb 22.
The prognosis of patients with liver metastasis of cervical cancer is poor with an extremely short survival period, and there have been no reports of cervical cancer complicated by portal vein tumor thrombosis (PVTT). We report a case of cervical cancer developing liver metastasis with PVTT. A 49-year-old woman developed liver metastasis from cervical cancer with PVTT. The primary tumor was locally controlled with multidisciplinary treatment, including systemic therapy, surgical resection, and radiation. However, her follow-up abdominal computed tomography results showed two irregular tumors in the liver's segments 2 and 6. From the latter lesion, a low-density filling defect extended to the posterior branch of the portal vein, suggesting PVTT. Hepatectomy of the two metastases was performed to prevent portal vein obstruction during subsequent chemotherapy. Pathological analysis revealed metastatic squamous cell carcinoma from cervical cancer that developed a tumor thrombus at the posterior branch of the portal vein. The patient received adjuvant chemotherapy, but died 10 months after surgery for recurrent liver metastasis. We present the first case of liver resection for liver metastasis from cervical cancer with PVTT. Although cervical cancer with PVTT is associated with a poor prognosis, surgical resection is a feasible option for preventing portal vein obstruction during subsequent chemotherapy.
宫颈癌肝转移患者的预后极差，生存期极短，且尚无宫颈癌合并门静脉癌栓（PVTT）的报道。我们报告了 1 例宫颈癌合并 PVTT 导致肝转移的病例。1 例 49 岁女性因宫颈癌发生肝转移伴 PVTT。通过多学科治疗（包括系统治疗、手术切除和放疗）控制了原发肿瘤，但她的后续腹部 CT 结果显示肝脏第 2 和 6 段有两个不规则肿瘤。后者病变中，低密度充盈缺损延伸至门静脉后支，提示存在 PVTT。为防止后续化疗时门静脉阻塞，对两个转移灶行肝切除术。病理分析显示转移性腺癌来源于宫颈癌，在门静脉后支形成肿瘤血栓。患者接受了辅助化疗，但因复发性肝转移术后 10 个月死亡。我们首次报道了宫颈癌合并 PVTT 行肝转移灶切除术的病例。虽然宫颈癌合并 PVTT 预后不良，但手术切除是预防后续化疗时门静脉阻塞的可行选择。
