Abdelsamia Mahmoud, Mosalem Osama, Gogineni Venumadhavi, Gullapalli Keerthi, Olomu Eghosa
Internal Medicine, Michigan State University/Sparrow Hospital, Lansing, USA.
Internal Medicine, Michigan State University, East Lansing, USA.
Cureus. 2022 May 10;14(5):e24876. doi: 10.7759/cureus.24876. eCollection 2022 May.
Synchronous gynecological malignancies are rarely encountered, with a growing tide to recognize these primary tumors. However, the most observed synchronous gynecological malignancies remain ovarian and endometrial cancer. This case report presents a 35-year-old female who presented to her gynecologist with lower back pain and dysuria. Transvaginal ultrasound demonstrated a 3-4 cm irregular mass in the cervix and lower uterine segment. Pathology from cold knife conization and endometrial curetting showed serous adenocarcinoma with probable lymphovascular invasion. The patient underwent a positron emission tomography scan that demonstrated an abnormal-appearing cervix, a small number of ascites, peritoneal carcinomatosis, and abnormal left adnexa. Eighteen days later, the patient underwent exploratory laparotomy with total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and bowel resection. Surgical histopathological findings confirmed the presence of two primary malignant tumors, namely, cervical adenosquamous carcinoma and bilateral ovarian high-grade serous carcinoma, with extensive metastatic lesions. Although synchronous ovarian and cervical cancer is rarely encountered, patients might benefit from early identification and subsequent debulking surgery with curative intent, as well as adding an immune checkpoint inhibitor in case it is positive on checking as it might improve long-term outcomes.
同步性妇科恶性肿瘤很少见，目前越来越倾向于识别这些原发性肿瘤。然而，最常见的同步性妇科恶性肿瘤仍然是卵巢癌和子宫内膜癌。本病例报告介绍了一名35岁女性，她因下背部疼痛和排尿困难就诊于妇科医生。经阴道超声显示宫颈和子宫下段有一个3-4厘米的不规则肿块。冷刀锥切术和子宫内膜刮宫术的病理结果显示为浆液性腺癌，可能有淋巴血管浸润。患者接受了正电子发射断层扫描，结果显示宫颈外观异常、少量腹水、腹膜癌转移以及左侧附件异常。18天后，患者接受了剖腹探查术，包括全腹子宫切除术、双侧输卵管卵巢切除术、大网膜切除术、淋巴结切除术和肠切除术。手术组织病理学检查结果证实存在两种原发性恶性肿瘤，即宫颈腺鳞癌和双侧卵巢高级别浆液性癌，并伴有广泛的转移病灶。虽然同步性卵巢癌和宫颈癌很少见，但患者可能会从早期识别以及随后进行的旨在治愈的减瘤手术中获益，并且如果检查结果呈阳性，添加免疫检查点抑制剂可能会改善长期预后。
