Kechagias Konstantinos S, Zafeiri Marina, Katsikas Triantafyllidis Konstantinos, Kyrtsonis Georgios, Geropoulos Georgios, Lyons Deirdre, Burney Ellis Laura, Bowden Sarah, Galani Apostolia, Paraskevaidi Maria, Kyrgiou Maria
Society of Meta-Research and Biomedical Innovation, London W12 0FD, UK.
Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2BX, UK.
Biology (Basel). 2023 Mar 2;12(3):398. doi: 10.3390/biology12030398.
Primary malignant melanoma (MM) of the cervix uteri is a rare and aggressive malignancy of the female reproductive tract. Considering that clinical data on this cancer are scarce, we aimed to comprehensively examine the currently available literature and provide an overview of the reported cases of cervical MM focusing on the clinical characteristics, diagnosis and therapeutic management. We conducted a systematic review of the literature by screening three electronic databases until June 2022. The critical appraisal checklist provided by the Joanna Briggs Institute was employed to evaluate the overall quality of the studies. We included 96 reports, which comprised 137 patients diagnosed with MM of the cervix. The mean age of the patients was 56.5 (median: 58, age range: 33-88). Data regarding menopausal status were provided for 98 patients with 15 being premenopausal and 83 being postmenopausal. The most common presenting symptom was vaginal bleeding (83%, 100/121). Biopsy (either excisional or punch biopsy) was used as the first diagnostic modality in most of the patients (67%, 64/95), followed by cytology (18%, 17/95). In 74 cases, the FIGO staging system for cervical cancer was used with the most common stage being FIGO stage I (38%, 28/74), followed by FIGO stage II (36%, 27/74), FIGO stage III (19%, 14/74) and FIGO stage IV (7%, 5/74). Most of the patients were managed surgically (90%, 119/131) with a hysterectomy (either radical or total), and a salpingo-oophorectomy with/without lymphadenectomy was the most common approach utilized (40%, 48/119). The data of clinical outcomes were provided for 105 patients, of whom 61 died (58%, 61/105) and 44 survived (42%, 44/105). Knowledge regarding the rare occurrence of MM in the cervix and the increased awareness of clinicians can prevent clinical misdiagnosis and ultimately improve further the clinical outcomes of patients developing this rare malignancy.
子宫颈原发性恶性黑色素瘤（MM）是女性生殖道一种罕见且侵袭性强的恶性肿瘤。鉴于关于这种癌症的临床数据稀缺，我们旨在全面审视当前可得的文献，并概述已报道的子宫颈MM病例，重点关注其临床特征、诊断及治疗管理。我们通过筛选三个电子数据库对文献进行了系统综述，直至2022年6月。采用乔安娜·布里格斯研究所提供的关键评估清单来评估研究的整体质量。我们纳入了96篇报告，其中包括137例被诊断为子宫颈MM的患者。患者的平均年龄为56.5岁（中位数：58岁，年龄范围：33 - 88岁）。为98例患者提供了绝经状态数据，其中15例为绝经前，83例为绝经后。最常见的症状是阴道出血（83%，100/121）。活检（切除活检或穿刺活检）在大多数患者中（67%，64/95）被用作首要诊断方式，其次是细胞学检查（18%，17/95）。在74例病例中，使用了子宫颈癌的国际妇产科联盟（FIGO）分期系统，最常见的分期是FIGO I期（38%，28/74），其次是FIGO II期（36%，27/74）、FIGO III期（19%，14/74）和FIGO IV期（7%，5/74）。大多数患者接受了手术治疗（90%，119/131），子宫切除术（根治性或全子宫切除术）以及双侧输卵管卵巢切除术伴或不伴淋巴结清扫术是最常用的方法（40%，48/119）。为105例患者提供了临床结局数据，其中61例死亡（58%，61/105），44例存活（42%，44/105）。了解子宫颈MM的罕见发生情况以及提高临床医生的认识可以防止临床误诊，并最终进一步改善罹患这种罕见恶性肿瘤患者的临床结局。
