Document Type : Case report
Professor, Department of Obstetrics and Gynecology, Fellowship in Gynecologic Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Associate Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Resident Fellowship in Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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.