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乙状结肠转移来自宫颈鳞状细胞癌:一例罕见病例报告并文献复习。

Sigmoid colonic metastasis from a squamous cell carcinoma of the cervix: A rare case report with literature review.

机构信息

Departments of Pathology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.

出版信息

Medicine (Baltimore). 2024 Jan 19;103(3):e37001. doi: 10.1097/MD.0000000000037001.

DOI:10.1097/MD.0000000000037001
PMID:38241535
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10798777/
Abstract

RATIONALE

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.

PATIENT CONCERNS

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.

DIAGNOSES

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.

INTERVENTIONS

Sigmoid colon resection with lymph node dissection followed by adjuvant chemotherapy (paclitaxel, carboplatin, and paprillizumab) was performed on the patient.

OUTCOMES

The patient was disease-free 16 months after surgery.

LESSONS SUBSECTIONS

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.

摘要

背景

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。

病例报告

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。

诊断

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。

治疗

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)。

结果

患者手术后 16 个月无病生存。

教训小节

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1917/10798777/43fc1c81a5a9/medi-103-e37001-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1917/10798777/d9545c7aa888/medi-103-e37001-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1917/10798777/f3e6b480143a/medi-103-e37001-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1917/10798777/43fc1c81a5a9/medi-103-e37001-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1917/10798777/d9545c7aa888/medi-103-e37001-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1917/10798777/f3e6b480143a/medi-103-e37001-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1917/10798777/43fc1c81a5a9/medi-103-e37001-g003.jpg

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A case report of an unusual caecal metastatic location of a primary cervical squamous cell carcinoma.一例原发性宫颈鳞状细胞癌罕见的盲肠转移病例报告。
J Surg Case Rep. 2020 Oct 31;2020(10):rjaa443. doi: 10.1093/jscr/rjaa443. eCollection 2020 Oct.
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Squamous cell carcinoma of cervix origin with rare metastasis to the colon.宫颈来源的鳞状细胞癌伴罕见的结肠转移。
AME Case Rep. 2018 May 15;2:23. doi: 10.21037/acr.2018.05.02. eCollection 2018.
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Postoperation of cervical cancer with intestine metastasis: a case report and literature review.
宫颈癌伴肠转移术后:1例病例报告及文献复习
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Indian J Cancer. 2011 Apr-Jun;48(2):267-8. doi: 10.4103/0019-509X.82893.
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Human papillomavirus and cervical cancer.人乳头瘤病毒与宫颈癌
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Squamous carcinoma of the colorectum and its genesis.结直肠癌鳞状细胞癌及其发生
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