Selvaggi L E, Di Vagno G, Loverro G, Masotina A, Cramarossa D, Napoli A, Resta L
I Clinica Ostetrica e Ginecologica, University of Bari Medical School, Italy.
Eur J Gynaecol Oncol. 1993;14(5):398-401.
We report the case of an unsuspected G.I. cancer in a patient with no clinical signs other than ascites and positive PAP-smear on admission. Histologically, neither endometrium nor cervix were involved. To date, only 2 cases of primary gastrointestinal (gastric) cancers with no metastases to the cervix, suspected by PAP-smear, have been reported in medical literature. A few more have been reported with cervical metastases. The suspicion of intraabdominal adenocarcinoma was based on the evidence of signet ring cells found in the smear with negative cervical biopsies and negative fractional curettage. A postmortem examination confirmed the absence of genital involvement. Our aim is to remind the clinician that an abnormal PAP-smear, due to non gynecological malignancies, can, on rare occasions, be observed. In order to obtain a positive cervico-vaginal PAP-smear by a non gynecologic intraabdominal exfoliating cancer, both previous literature and our case suggest peritoneal effusion to be of major importance.
我们报告了一例未被怀疑患有胃肠道癌症的患者，该患者入院时除腹水和巴氏涂片阳性外无其他临床症状。组织学检查显示，子宫内膜和宫颈均未受累。迄今为止，医学文献中仅报道了2例原发性胃肠道（胃）癌，通过巴氏涂片怀疑有宫颈转移但实际未发生转移的病例。另有一些病例报告了伴有宫颈转移的情况。腹腔内腺癌的怀疑基于涂片检查中发现印戒细胞，而宫颈活检和分段刮宫均为阴性的证据。尸检证实不存在生殖器受累情况。我们的目的是提醒临床医生，非妇科恶性肿瘤偶尔也会导致巴氏涂片异常。为了通过非妇科腹腔内脱落性癌症获得宫颈阴道巴氏涂片阳性结果，既往文献和我们的病例均提示腹腔积液至关重要。
