Lugata John, Smith Caleigh, Shao Baraka, Mremi Alex, Mchome Bariki
Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH, USA.
Int J Surg Case Rep. 2024 Nov;124:110349. doi: 10.1016/j.ijscr.2024.110349. Epub 2024 Sep 25.
Cervical carcinosarcomas (CCS) are uncommon aggressive gynecological malignancies that typically occur in postmenopausal females. Data on CCS, incidence, clinical presentation, magnitude and management strategies remain scarce especially in Sub-Saharan countries like Tanzania. In this report, we report the rarity of this particular condition in premenopausal woman, the literature surrounding similar reports, and the many challenges that arise in the management of CCS.
We present a redudancy case of a 35-year-old female from Northern Tanzania who presented with vaginal bleeding, foul smelling discharge, and severe abdominal pain intermittently for a year. The Speculum exam revealed a fungating mass on the cervix, and CT confirmed the irregular mass centered in the uterine cervix expanding in the fornices infiltrating the uterine neck. A cervical biopsy revealed carcinosarcoma of the cervix stage IIA. Due to the patient's instability, she was admitted and started on chemotherapy and later on recommended for radiation without surgical intervention.
In this case report, we discuss the condition's rarity and multiple barriers we encountered during management of this complicated patient with CCS. Choosing an optimal treatment approach was challenging due to the lack of guidelines and available literature as well as the patient's instability.
his case is notable due to the rarity of this cervical neoplasm especially in premenopausal women and the challenging management of the condition due to a notable lack of treatment recommendations.
宫颈癌肉瘤(CCS)是一种罕见的侵袭性妇科恶性肿瘤,通常发生在绝经后女性中。关于CCS的发病率、临床表现、严重程度及管理策略的数据仍然匮乏,尤其是在坦桑尼亚等撒哈拉以南国家。在本报告中,我们报告了这种特殊情况在绝经前女性中的罕见性、围绕类似报告的文献以及CCS管理中出现的诸多挑战。
我们呈现了一例来自坦桑尼亚北部的35岁女性的病例,该患者间歇性出现阴道出血、恶臭分泌物及严重腹痛达一年之久。窥器检查发现宫颈有一个蕈样肿物,CT证实该不规则肿物位于子宫颈,向穹窿扩展并浸润子宫颈管。宫颈活检显示为IIA期宫颈肉瘤。由于患者情况不稳定,她入院接受化疗,随后在未进行手术干预的情况下被建议接受放疗。
在本病例报告中,我们讨论了该病症的罕见性以及在管理这位患有CCS的复杂患者过程中遇到的多重障碍。由于缺乏指南和可用文献以及患者情况不稳定,选择最佳治疗方法具有挑战性。
该病例值得关注,因为这种宫颈肿瘤罕见,尤其是在绝经前女性中,且由于明显缺乏治疗建议,该病症的管理具有挑战性。