Departments of Pathology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
Medicine (Baltimore). 2024 Jan 19;103(3):e37001. doi: 10.1097/MD.0000000000037001.
As the third most common cancer in women, cervical cancer usually spreads to adjacent organs. Distant metastasis from the cervix to the gastrointestinal tract is an extremely rare occurrence.
Herein, we present a rare case of a 57-year-old woman who was treated by hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy for squamous cell carcinoma (SCC) of the uterine cervix. A metastatic location in the sigmoid colon was revealed after 8 years causing an acute intestinal obstruction in this patient.
Final surgical pathology showed an invasive lesion with squamous differentiation in full thickness of the colon wall from mucosa to serosa. Meanwhile, the results of immunohistochemistry (IHC) showed the cancer cells were positive for CK5/6, P63, P40, and P16 confirming the diagnosis of metastatic sigmoid colonic carcinoma originating from SCC of the uterine cervix.
Sigmoid colon resection with lymph node dissection followed by adjuvant chemotherapy (paclitaxel, carboplatin, and paprillizumab) was performed on the patient.
The patient was disease-free 16 months after surgery.
SCC is one of the rare malignant tumors of the gastrointestinal tract occurring as either a primary or secondary lesion. However, the secondary SCC of the colon has a poorer prognosis compared with the primary SCC. Therefore, colonic metastasis must be considered in the differential diagnosis of acute intestinal obstruction, especially in patients with the medical history of SCC in other organs.
宫颈癌是女性第三大常见癌症,通常会扩散到邻近器官。宫颈转移至胃肠道的远处转移极为罕见。
本文报道了 1 例罕见病例,患者为 57 岁女性,因宫颈鳞状细胞癌(SCC)接受了子宫切除术和双侧输卵管卵巢切除术及盆腔淋巴结切除术。8 年后,该患者出现乙状结肠转移,导致急性肠梗阻。
最终的手术病理显示,从黏膜到浆膜全层的结肠壁有浸润性鳞状分化病变。同时,免疫组织化学(IHC)结果显示癌细胞 CK5/6、P63、P40 和 P16 阳性,证实了转移性乙状结肠癌来源于宫颈 SCC 的诊断。
对患者进行了乙状结肠切除术和淋巴结清扫术,并辅以辅助化疗(紫杉醇、卡铂和帕博利珠单抗)。
患者手术后 16 个月无病生存。
SCC 是胃肠道罕见的恶性肿瘤之一,可作为原发性或继发性病变发生。然而,与原发性 SCC 相比,结肠的继发性 SCC 预后更差。因此,在急性肠梗阻的鉴别诊断中,尤其是在其他器官有 SCC 病史的患者中,必须考虑结肠转移的可能性。