Palicelli Andrea, Tonni Gabriele, Torricelli Federica, Melli Beatrice, Cusenza Vincenza Ylenia, Martinelli Sandra, Zanetti Eleonora, Bisagni Alessandra, Zanelli Magda, Bonasoni Maria Paola, Rossi Teresa, Mangone Lucia, Medina-Illueca Venus Damaris, Zizzo Maurizio, Morini Andrea, Broggi Giuseppe, Caltabiano Rosario, Salzano Serena, Sanguedolce Francesca, Koufopoulos Nektarios I, Boutas Ioannis, Asaturova Aleksandra, Casartelli Chiara, Rubagotti Sara, Crotti Matteo, Aguzzoli Lorenzo, Mandato Vincenzo Dario
Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy.
Cancers (Basel). 2025 Aug 27;17(17):2801. doi: 10.3390/cancers17172801.
: Rarely, primary (PriCs) or metastatic (metECs) carcinomas occur in the episiotomy site. : A systematic literature review of metECs was carried out. We reviewed the PRISMA guidelines and the Scopus, Pubmed, and Web of Science databases. : We found 21 carcinomas; all of them were cervical carcinomas (11 squamous, SCC; 6 adenocarcinomas; 3 adenosquamous; 1 SCC or adenocarcinoma) diagnosed during pregnancy (38%) or 0.25-8 months postpartum (57%). SCCs were larger (mean size: 4.8 cm). At presentation, only two cases were pN+, and no distant metastases were found, excluding four episiotomy metastases (one anticipating the cervical cancer diagnosis); the remaining episiotomy metastases (mean size: 3 cm; one multifocal) were found at follow-up (these were first metastases in 86% of cases). The time range from the episiotomy/last delivery to first episiotomy metastasis was 1-66 (mean, 12.3) months. Treatment was variable: hysterectomy (71%) ± lymphadenectomy (67%) and/or adjuvant treatment (19%); chemoradiation/radiotherapy alone (24%). A total of 90% of cases recurred after 18 days to 66 months (mean, 12 months). At last follow-up, ten patients (48%) were disease-free after 12-120 (mean, 63.5) months, two patients (10%) were alive with disease, and nine (42%) patients died of disease after 6-36 (mean, 12.5) months (including two never-cleared/progressing cases). : PriCs and metECs are rare. Iatrogenic/obstetric implantation or vascular dissemination of cervical cancer at the site of episiotomy may occur. For episiotomy lesions, accurate gynecological/perineal examination is required, and biopsy can be considered. Larger studies are required in order to determine treatment guidelines. Compared to PriCs, metECs occurred in younger (premenopausal) patients, were not associated with endometriosis, and demonstrated slightly smaller size and shorter mean time from episiotomy to episiotomy metastases, with a higher likelihood of a less favorable prognosis.
很少有原发性（原发性会阴癌，PriCs）或转移性（会阴转移癌，metECs）癌发生于会阴切开术部位。
开展了一项关于会阴转移癌的系统文献综述。我们查阅了PRISMA指南以及Scopus、Pubmed和科学网数据库。
我们发现了21例癌症；所有病例均为宫颈癌（11例鳞状细胞癌，SCC；6例腺癌；3例腺鳞癌；1例SCC或腺癌），其中38%在孕期确诊，57%在产后0.25 - 8个月确诊。鳞状细胞癌更大（平均大小：4.8厘米）。初诊时，仅2例为pN +，未发现远处转移，排除4例会阴转移（1例早于宫颈癌诊断）；其余会阴转移（平均大小：3厘米；1例多灶性）在随访时发现（86%的病例中这些是首次转移）。从会阴切开术/最后一次分娩到首次会阴转移的时间范围为1 - 66个月（平均12.3个月）。治疗方式多样：子宫切除术（71%）±淋巴结清扫术（67%）和/或辅助治疗（19%）；单纯放化疗/放疗（24%）。总共90%的病例在18天至66个月（平均12个月）后复发。在最后一次随访时，10例患者（48%）在12 - 120个月（平均63.5个月）后无疾病，2例患者（10%）带瘤生存，9例（42%）患者在6 - 36个月（平均12.5个月）后死于疾病（包括2例未清除/进展病例）。
原发性会阴癌和会阴转移癌很罕见。宫颈癌可能在会阴切开术部位发生医源性/产科植入或血管播散。对于会阴切开术病变，需要进行准确的妇科/会阴检查，可考虑活检。需要开展更大规模的研究以确定治疗指南。与会阴原发性癌相比，会阴转移癌发生于更年轻（绝经前）的患者，与子宫内膜异位症无关，且平均大小略小，从会阴切开术到会阴转移的平均时间更短，预后较差的可能性更高。
