Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea.
Department of Radiology, Pusan National University School of Medicine, Busan, South Korea.
Medicine (Baltimore). 2022 Nov 11;101(45):e31579. doi: 10.1097/MD.0000000000031579.
A poorly differentiated lymphoepithelioma-like carcinoma (LELC) of the cervix is an extremely rare presentation. We herein present an unusual case of LELC of the cervix, which was treated with radical trachelectomy for fertility preservation.
A 28-year-old female patient presented with a 1-month-history of post-coital vaginal bleeding, and a 2 cm tumor was found on gynecological sonography and magnetic resonance imaging.
The final pathological examination established a conclusive diagnosis of LELC of the cervix. After surgery, the patient was finally diagnosed as The International Federation of Gynecology and Obstetrics (FIGO) stage IB1 with no vaginal wall or parametrium infiltration.
Subsequently, a surgery was scheduled, and intraoperatively, we performed resection twice because of a frozen biopsy result that was resection margin-positive initially. As a result, further resection was performed, which was a 5mm thickness for each. Cisplatin adjuvant chemotherapy was administered 3 weeks after the operation to prevent recurrence.
The patient has been followed for 1 year postoperatively, with an adjuvant treatment, with no evidence of tumor recurrence or metastasis.
Based on this case, we highly recommend that operators should consider a deeper resection margin range than that visible on magnetic resonance imaging. More attention is needed to better understand the treatment method for LELC of the cervix. We also plan to closely monitor the patient's prognosis and fertility, and to conduct additional studies.
宫颈低分化淋巴上皮样癌(LELC)极为罕见。本文报道了 1 例宫颈 LELC 患者,为保留生育能力,行根治性宫颈切除术。
患者,28 岁,因性交后阴道出血 1 个月就诊,妇科超声和磁共振成像发现 2 cm 大小肿瘤。
最终病理检查明确诊断为宫颈 LELC。术后诊断为国际妇产科联盟(FIGO)IB1 期,未见阴道壁或宫旁浸润。
随后安排手术,由于首次冰冻活检结果提示切缘阳性,故术中行 2 次切除。结果发现进一步切除 5mm 厚度,术后 3 周给予顺铂辅助化疗,以预防复发。
患者术后随访 1 年,接受辅助治疗,未见肿瘤复发或转移。
基于此病例,我们强烈建议术者考虑比磁共振成像所见更宽的切缘范围。为了更好地理解宫颈 LELC 的治疗方法,需要更加关注。我们还计划密切监测患者的预后和生育能力,并进行进一步研究。