Mai Y L, Lin H H, Chang D Y, Chen C K, Cheng W F, Tseng G C, Huang S C
Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, ROC.
J Formos Med Assoc. 1996 Jan;95(1):73-5.
Cervical carcinoma spreads predominantly by lymphatic routes and lymph node metastases may occur even in early stages of disease. Metastases usually first appear in pelvic lymph nodes, then disseminate along the efferent lymphatic chain to the extrapelvic lymph nodes. Cases of positive lymph node metastases with negative pelvic nodes in invasive cervical carcinoma are extremely rare. We report a 50-year-old woman with bulky stage IIA cervical carcinoma who had scalene lymph node metastases in the absence of pelvic lymph node metastases after radical hysterectomy and postoperative pelvic irradiation. This rare "skipping" nodal metastasis was probably via posterior trunk lymphatic drainage of the bulky cervical carcinoma which mainly invaded the posterior vaginal cuff. Neoadjuvant or adjuvant chemotherapy is recommended to prolong survival of patients in such cases.
宫颈癌主要通过淋巴途径扩散，甚至在疾病早期就可能发生淋巴结转移。转移通常首先出现在盆腔淋巴结，然后沿输出淋巴管链扩散至盆腔外淋巴结。浸润性宫颈癌中盆腔淋巴结阴性而淋巴结转移阳性的病例极为罕见。我们报告一名50岁患有巨大IIA期宫颈癌的女性，在根治性子宫切除术后和术后盆腔放疗后出现了斜角肌淋巴结转移，而盆腔淋巴结未转移。这种罕见的“跳跃式”淋巴结转移可能是通过主要侵犯阴道后穹隆的巨大宫颈癌的后干淋巴引流途径。在这种情况下，建议进行新辅助或辅助化疗以延长患者生存期。
