Synchronous Cervical Adenocarcinoma Combined with Ovarian Cancer: A Case Report and Literature Review

doi:10.12280/gjszjk.20230098

Abstract

Abstract:

A rare case of dual primary cancer which combined synchronous cervical adenocarcinoma with ovarian cancer was reported. The patient was a 56-year-old female. The main clinical manifestations were abnormal vaginal bleeding and lower abdominal pain. The levels of serum tumor markers were significantly elevated, pelvic CT showed the decreased patular enhancement of the posterior uterine wall, and electronic colposcopy biopsy showed the high-grade intraepithelial neoplasia of some glandular epithelium, more severe lesions not excluded. On June 2, 2020, the patient underwent the operation of exploratory laparotomy + enlarged hysterectomy + bilateral adnexectomy + pelvic adhesion release + pelvic lymph node dissection + abdominal drainage under endotracheal intubation and general anesthesia, and then underwent 6 times of chemotherapy and 1 time of pelvic three-dimensional conformal intensive radiotherapy. Later, she died due to the intestinal obstruction caused by tumor recurrence. The case data of cervical cancer combined with ovarian cancer were reviewed, in order to improve clinicians′ understanding of gynecological dual primary cancer.

Key words: Neoplasms, multiple primary, Gastric-type endocervical adenocarcinoma, Ovarian neoplasms, Therapy, Prognosis

WANG Min, AN Rong, ZHANG Jing, QI Qi, XU Fei-xue. Synchronous Cervical Adenocarcinoma Combined with Ovarian Cancer: A Case Report and Literature Review[J]. Journal of International Reproductive Health/Family Planning, 2023, 42(5): 387-391.

Figures/Tables 5

References 20

[1]	Lin CK, Yu MH, Chu TW, et al. Synchronous occurrence of primary neoplasms in the uterus with squamous cell carcinoma of the cervix and adenocarcinoma of the endometrium[J]. Taiwan J Obstet Gynecol, 2006, 45(4):336-339. doi: 10.1016/S1028-4559(09)60255-2. doi: 10.1016/S1028-4559(09)60255-2 URL
[2]	Eisner RF, Nieberg RK, Berek JS. Synchronous primary neoplasms of the female reproductive tract[J]. Gynecol Oncol, 1989, 33(3):335-339. doi: 10.1016/0090-8258(89)90523-4. doi: 10.1016/0090-8258(89)90523-4 pmid: 2722060
[3]	Ayhan A, Yalçin OT, Tuncer ZS, et al. Synchronous primary malignancies of the female genital tract[J]. Eur J Obstet Gynecol Reprod Biol, 1992, 45(1):63-66. doi: 10.1016/0028-2243(92)90195-5. doi: 10.1016/0028-2243(92)90195-5 pmid: 1618363
[4]	Tong SY, Lee YS, Park JS, et al. Clinical analysis of synchronous primary neoplasms of the female reproductive tract[J]. Eur J Obstet Gynecol Reprod Biol, 2008, 136(1):78-82. doi: 10.1016/j.ejogrb.2006.09.010. doi: 10.1016/j.ejogrb.2006.09.010 URL
[5]	Woodruff JD, Julian CG. Multiple malignancy in the upper genital canal[J]. Am J Obstet Gynecol, 1969, 103(6):810-822. doi: 10.1016/0002-9378(69)90579-1. doi: 10.1016/0002-9378(69)90579-1 pmid: 5765964
[6]	Sica V, Nola E, Contieri E, et al. Estradiol and progesterone receptors in malignant gastrointestinal tumors[J]. Cancer Research, 1984, 44(10):4670-4674. pmid: 6467220
[7]	Fornander T, Rutqvist LE, Cedermark B, et al. Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers[J]. Lancet, 1989, 1(8630):117-120. doi: 10.1016/s0140-6736(89)91141-0. doi: 10.1016/s0140-6736(89)91141-0 pmid: 2563046
[8]	Kojima A, Mikami Y, Sudo T, et al. Gastric morphology and immunophenotype predict poor outcome in mucinous adenocarcinoma of the uterine cervix[J]. Am J Surg Pathol, 2007, 31(5):664-672. doi: 10.1097/01.pas.0000213434.91868.b0. doi: 10.1097/01.pas.0000213434.91868.b0 pmid: 17460448
[9]	Ehmann S, Sassine D, Straubhar AM, et al. Gastric-type adenocarcinoma of the cervix: Clinical outcomes and genomic drivers[J]. Gynecol Oncol, 2022, 167(3):458-466. doi: 10.1016/j.ygyno.2022.10.003. doi: 10.1016/j.ygyno.2022.10.003 pmid: 36253302
[10]	Lu B, Shi H, Shao Y, et al. Ovarian Metastasis by Gastric-type Endocervical Adenocarcinoma: A Clinicopathologic Description of 12 Cases[J]. Int J Gynecol Pathol, 2022, 41(4):356-365. doi: 10.1097/PGP.0000000000000815. doi: 10.1097/PGP.0000000000000815 URL
[11]	Bacalbasa N, Balescu IC, Diaconu C, et al. Synchronous Cervical Adenocarcinoma and Ovarian Serous Adenocarcinoma-A Case Report and Literature Review[J]. Medicina(Kaunas), 2020, 56(4)152. doi: 10.3390/medicina56040152. doi: 10.3390/medicina56040152
[12]	Young RH, Scully RE. Mucinous ovarian tumors associated with mucinous adenocarcinomas of the cervix. A clinicopathological analysis of 16 cases[J]. Int J Gynecol Pathol, 1988, 7(2):99-111. doi: 10.1097/00004347-198805000-00001. doi: 10.1097/00004347-198805000-00001 pmid: 2840404
[13]	Sunku R, Duggal R, Patel FD, et al. Cervical embryonal rhabdomyosarcoma and ovarian Sertoli-Leydig cell tumor with congenital absence of unilateral ovary[J]. J Cancer Res Ther, 2015, 11(3):654. doi: 10.4103/0973-1482.139522. doi: 10.4103/0973-1482.139522 pmid: 26458643
[14]	Talia KL, McCluggage WG. The developing spectrum of gastric-type cervical glandular lesions[J]. Pathology, 2018, 50(2):122-133. doi: 10.1016/j.pathol.2017.09.009. doi: 10.1016/j.pathol.2017.09.009 URL
[15]	Zhao W, Xiao Y, Zhao W, et al. Survival Outcomes in Patients With 2018 FIGO Stage ⅠA2-ⅡA2 Cervical Cancer Treated With Laparoscopic Versus Open Radical Hysterectomy: A Propensity Score-Weighting Analysis[J]. Front Oncol, 2021, 11:682849. doi: 10.3389/fonc.2021.682849. doi: 10.3389/fonc.2021.682849 URL
[16]	Adhya AK, Mohanty R. Triple synchronous tumour of female genital tract: cervical squamous cell carcinoma, right ovarian dermoid cyst and left ovarian benign Brenner tumour[J]. BMJ Case Rep, 2019, 12(7):e230695. doi: 10.1136/bcr-2019-230695. doi: 10.1136/bcr-2019-230695 URL
[17]	Zaino RJ, Unger ER, Whitney C. Synchronous carcinomas of the uterine corpus and ovary[J]. Gynecol Oncol, 1984, 19(3):329-335. doi: 10.1016/0090-8258(84)90200-2. doi: 10.1016/0090-8258(84)90200-2 pmid: 6500375
[18]	Abdelsamia M, Mosalem O, Gogineni V, et al. A Rare Case of Advanced Synchronous Primary Ovarian and Cervical Cancer[J]. Cureus, 2022, 14(5):e24876. doi: 10.7759/cureus.24876. doi: 10.7759/cureus.24876
[19]	Rosenberg P, Carinelli S, Peiretti M, et al. Cervical sarcoma botryoides and ovarian Sertoli-Leydig cell tumor: a case report and review of literature[J]. Arch Gynecol Obstet, 2012, 285(3):845-848. doi: 10.1007/s00404-011-2017-4. doi: 10.1007/s00404-011-2017-4 pmid: 21847587
[20]	Huang YD, Hung YC, Yeh LS, et al. Synchronous ovarian endometrioid adenocarcinoma and endocervical mucinous adenocarcinoma[J]. Taiwan J Obstet Gynecol, 2006, 45(3):264-267. doi: 10.1016/S1028-4559(09)60239-4. doi: 10.1016/S1028-4559(09)60239-4 URL

文献	患者年龄	症状	病理类型	治疗	辅助治疗	随访
Bacalbasa等^[11]	53岁	绝经后阴道出血、弥漫性盆腔疼痛、腹胀、呕吐、体质量减轻	宫颈黏液腺癌（ⅡA期）、卵巢浆液性腺癌（ⅢC期）	根治性子宫切除术+双侧附件切除术+盆腔和主动脉旁淋巴结清扫+大网膜切除术+盆腔腹膜切除术	铂类化疗，术后巩固化疗	未说明
Sunku等^[13]	16岁	月经频发、阴道肿物	宫颈胚胎性横纹肌肉瘤、左侧卵巢支持-间质细胞瘤	开腹探查术+全子宫切除术+左侧输卵管、卵巢切除术+大网膜切除术伴腹膜冲洗	长春新碱、阿霉素和环磷酰胺等辅助化疗	5年随访中无疾病复发证据
Abdelsamia等^[18]	35岁	腰痛、双侧髋关节疼痛、耻骨上疼痛、排尿困难	宫颈腺鳞癌（pT1bN1M1）、双侧卵巢高级别浆液性癌（pT3cN1bM1b）	开腹探查术+全子宫切除术+双侧附件切除术+大网膜切除术+淋巴结切除术+肠切除术	卡铂联合多西紫杉醇化疗、曲妥珠单抗、帕妥珠单抗、顺铂、多西他赛和贝伐珠单抗、派姆单抗、拓扑替康、多西紫杉醇和贝伐珠单抗	患者出现复发及全身多处转移，最终去世
Rosenberg等^[19]	20岁	无特殊不适	宫颈横纹肌肉瘤、卵巢支持-间质细胞瘤	开腹手术（具体术式未描述）	异环磷酰胺和表霉素联合化疗	6年后宫颈横纹肌肉瘤复发
Huang等^[20]	30岁	腹胀、胸闷和呼吸困难	卵巢子宫内膜样腺癌（Ⅲc期）、宫颈黏液腺癌（ⅠA1期）	分期手术，包括全子宫切除术、双侧附件切除术、盆腔淋巴结清扫、主动脉旁淋巴结取样、双侧漏斗韧带切除术、阑尾切除术、大网膜切除术	卡铂和紫杉醇联合化疗、吉西他滨、聚乙二醇化阿霉素盐酸脂质体	去世

文献	患者年龄	症状	病理类型	治疗	辅助治疗	随访
Bacalbasa等^[11]	53岁	绝经后阴道出血、弥漫性盆腔疼痛、腹胀、呕吐、体质量减轻	宫颈黏液腺癌（ⅡA期）、卵巢浆液性腺癌（ⅢC期）	根治性子宫切除术+双侧附件切除术+盆腔和主动脉旁淋巴结清扫+大网膜切除术+盆腔腹膜切除术	铂类化疗，术后巩固化疗	未说明
Sunku等^[13]	16岁	月经频发、阴道肿物	宫颈胚胎性横纹肌肉瘤、左侧卵巢支持-间质细胞瘤	开腹探查术+全子宫切除术+左侧输卵管、卵巢切除术+大网膜切除术伴腹膜冲洗	长春新碱、阿霉素和环磷酰胺等辅助化疗	5年随访中无疾病复发证据
Abdelsamia等^[18]	35岁	腰痛、双侧髋关节疼痛、耻骨上疼痛、排尿困难	宫颈腺鳞癌（pT1bN1M1）、双侧卵巢高级别浆液性癌（pT3cN1bM1b）	开腹探查术+全子宫切除术+双侧附件切除术+大网膜切除术+淋巴结切除术+肠切除术	卡铂联合多西紫杉醇化疗、曲妥珠单抗、帕妥珠单抗、顺铂、多西他赛和贝伐珠单抗、派姆单抗、拓扑替康、多西紫杉醇和贝伐珠单抗	患者出现复发及全身多处转移，最终去世
Rosenberg等^[19]	20岁	无特殊不适	宫颈横纹肌肉瘤、卵巢支持-间质细胞瘤	开腹手术（具体术式未描述）	异环磷酰胺和表霉素联合化疗	6年后宫颈横纹肌肉瘤复发
Huang等^[20]	30岁	腹胀、胸闷和呼吸困难	卵巢子宫内膜样腺癌（Ⅲc期）、宫颈黏液腺癌（ⅠA1期）	分期手术，包括全子宫切除术、双侧附件切除术、盆腔淋巴结清扫、主动脉旁淋巴结取样、双侧漏斗韧带切除术、阑尾切除术、大网膜切除术	卡铂和紫杉醇联合化疗、吉西他滨、聚乙二醇化阿霉素盐酸脂质体	去世