Metastatic Epithelial Ovarian Cancer to the Cervix: A Case Report

Document Type : Case report


1 Professor, Department of Obstetrics and Gynecology, Fellowship in Gynecologic Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Resident Fellowship in Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Ovarian cancer is a common malignancy in women, the major presentations of which are gastrointestinal symptoms. The intra-abdominal metastasis of ovarian cancer often occurs in the peritoneal cavity, while cervical metastasis has rarely been reported. This study aimed to present the case of a metastatic epithelial ovarian cancer to the cervix.
Case Report: A 58-year-old woman (gravida 3) was admitted with a history of postcoital bleeding in the oncology clinic of a teaching hospital affiliated to Mashhad University of Medical Sciences in 2016. Colposcopic examination was performed due to the abnormal appearance of the cervix, and pathology results confirmed squamous cervical cancer. Considering the early stage (II A) of the disease, the patient underwent a radical surgery. In laparotomy, due to the extent of the intra-abdominal metastasis similar to that of ovarian cancer, only omental biopsy was possible. The pathology report of the specimen showed the metastasis of the serous papillary adenocarcinoma of the ovary to the omentum. Furthermore, repeated review of the pathology of the cervical specimen was indicative of ovarian metastasis to the cervix. Due to the advanced stage of ovarian cancer, chemotherapy (taxol-carboplatin) was recommended, followed by standard optimal surgical cytoreduction. Afterwards, the patient was followed-up for ovarian cancer. After less than six months, she experienced pelvic and abdominal metastasis and is currently receiving palliative chemotherapy.
Conclusion: Cervical metastasis is an unusual occurrence at presentation and during the progression of epithelial ovarian cancer. As an initial symptom of ovarian cancer, postcoital bleeding is rare and should be considered in the patients with cervical cancer who are at the risk of metastatic lesions from the adjacent tissues.


  1. Lee JY, Noo SM, Cho NH, Choi YM, Yim GW, Lee M, et al. A rare case of primary adenosquamous carcinoma arising from ovary. J Womens Med 2010; 3(3):126-9.
  2. Na S, Hwang J, Lee H, Lee J, Lee D. Rapidly growing ovarian endometrioid adenocarcinoma involving the vagina: a case report. Taiwan J Obstet Gynecol 2011; 50(4):522-7.
  3. Chang MC, Nevadunsk NS, Viswanathan AN, Crum CP, Feltmate CM. Endocervical adenocarcinoma in situ with ovarian metastases: a unique variant with potential for long-term survival. Int J Gynecol Pathol 2009; 29(1):88-92.
  4. Ronnett BM, Yemelyanova AV, Vang R, Gilks CB, Miller D, Gravitt PE, et al. Endocervical adenocarcinomas with ovarian metastases: analysis of 29 cases with emphasis on minimally invasive cervical tumors and the ability of the metastases to simulate primary ovarian neoplasms. Am J Surg Pathol 2008; 32(12):1835-53.
  5. Pradeep S, Kim SW, Wu SY, Nishimura M, Chaluvally-Raghavan P, Miyake T, et al. Hematogenous metastasis of ovarian cancer: rethinking mode of spread. Cancer Cell 2014; 26(1):77-91.
  6. Shoji T, Takatori E, Murakami K, Kaido Y, Takeuchi S, Kikuchi A, et al. A case of ovarian adenosquamous carcinoma arising from endometrioid adenocarcinoma: a case report and systematic review. J Ovarian Res 2016; 9(1):48.
  7. Lengyel E. Ovarian cancer development and metastasis. Am J Pathol 2010; 177(3):1053-64.
  8. Malpica A, Deavers MT. Ovarian low-grade serous carcinoma involving the cervix mimicking a cervical primary. Int J Gynecol Pathol 2011; 30(6):613-9.
  9. McCluggage WG, Shah R, Connolly LE, McBride HA. Intestinal-type cervical adenocarcinoma in situ and adenocarcinoma exhibit a partial enteric immunophenotype with consistent expression of CDX2. Int J Gynecol Pathol 2008; 27(1):92-100
  10. Phillips V, Kelly P, McCluggage WG. Increased p16 expression in8- high-grade serous and undifferentiated carcinoma compared with other morphologic types of ovarian carcinoma. Int J Gynecol Pathol 2009; 28(2):179-86.
  11. Suarez-Penaranda JM, Abdulkader I, Baron-Duarte FJ, González Patiño E, Novo-Domínguez A, Varela-Durán J. Signet-ring cell carcinoma presenting in the uterine cervix: report of a primary and 2 metastatic cases. Int J Gynecol Pathol 2007; 26(3):254-8.
  12. Al-Hussaini M, Stockman A, Foster H, McCluggage WG. WT-1 assists in distinguishing ovarian from uterine serous carcinoma and in distinguishing between serous and endometrioid ovarian carcinoma. Histopathology 2004; 44(2):109-15.  

Mousavi AS, Behnamfar F, Mehrdad N. Recurrent metastasis of epithelial ovarian cancer in cervical, submandibular and suboccipital lymph nodes. J Med 2009; 10(2):128-31.