Otsuka Isao
Department of Obstetrics and Gynecology, Kameda Medical Center, Kamogawa, JPN.
Cureus. 2024 Feb 12;16(2):e54091. doi: 10.7759/cureus.54091. eCollection 2024 Feb.
Microinvasive squamous cell carcinoma of the cervix develops mainly in young women. As metastases rarely occur, cervical conization to preserve fertility is often performed. We report a case of peritoneal recurrence developed after conization. A 31-year-old nulligravid woman with microinvasive squamous cell carcinoma of the cervix was treated with laser conization. Pathology showed a stromal invasion of <1 mm and a longitudinal spread of 3 mm without lymphovascular space involvement. Forty-seven months after conization, a pelvic examination revealed a firm, immobile mass on the right side of the pelvis. Transvaginal ultrasonography and magnetic resonance imaging showed a 3.8-cm solid mass located right of the rectum and anterior to the sacrum. A fine-needle biopsy showed squamous cell carcinoma. The tumor was diagnosed as a metastasis of cervical carcinoma. After salvage concurrent chemoradiation, the patient was well and had no evidence of disease at 90 months after the treatment. In this case, tumor cells appear to spread through the endometrial cavity and the lumen of the fallopian tube.
宫颈微浸润鳞状细胞癌主要发生于年轻女性。由于很少发生转移，常进行宫颈锥切术以保留生育能力。我们报告一例锥切术后发生腹膜复发的病例。一名31岁未孕女性，患有宫颈微浸润鳞状细胞癌，接受了激光锥切术治疗。病理显示间质浸润<1mm，纵向扩散3mm，无脉管间隙受累。锥切术后47个月，盆腔检查发现盆腔右侧有一质地硬、固定不动的肿块。经阴道超声和磁共振成像显示，直肠右侧、骶骨前方有一个3.8cm的实性肿块。细针穿刺活检显示为鳞状细胞癌。该肿瘤被诊断为宫颈癌转移。在挽救性同步放化疗后，患者情况良好，治疗后90个月无疾病证据。在本病例中，肿瘤细胞似乎通过子宫内膜腔和输卵管腔扩散。
