[Show abstract][Hide abstract] ABSTRACT: Background : We report a case of advanced cervical cancer with a large retroperitoneal lymph node metastasis, which was preoperatively misdiagnosed as a uterine leiomyoma.Case : A 43-year-old woman was referred to our department for pelvic pain. Gynecological examination revealed unremarkable findings. Transvaginal ultrasound and magnetic resonance imaging showed a solid mass measuring around 6 cm in diameter in the upper pelvis. Based on the findings, this solid mass was diagnosed as a subserosal uterine leiomyoma. Cervical and endometrial smears showed no malignant findings. The patient was taken up for surgery, when it became apparent that the mass was retroperitoneal, probably a lymph node swelling. Biopsy of the mass revealed the presence of metastatic highly differentiated squamous cell carcinoma.Conclusion : Systemic examination for the primary site resulted in vain. No primary cancer could be detected. Then, cervical cytology and endocervical curettage were performed again, which led to the diagnosis of cervical cancer. Finally, the uterine cervix was determined to be the primary origin of the retroperitoneal lymph node metastasis.
[Show abstract][Hide abstract] ABSTRACT: A 79-year-old woman was referred to our hospital with complaints of dyspnea. She was diagnosed with massive pleural effusion and cytology demonstrated the presence of adenocarcinoma, but no solid tumors were found in the systemic examination. Her serum CYFRA and CA125 level were increased. She was diagnosed with an effusion type of lung cancer or a cancer of unknown origin. S-1/CDDP was the chemotherapy of choice. After 2 courses of the treatment, her serum CYFRA level and CA125 level were normalized, and a chest CT detected no pleural effusion. Two years and 3 months after the first treatment, her CA125 level was increased. We found an FDG accumulation in her pelvic lesion by PET examination. To identify the FDG accumulated lesion in her pelvis, an operation was performed. Histopathological examination of the right ovary demonstrated the presence of an adenocarcinoma. Postoperatively, we administered 2 courses of paclitaxel/carboplatin combination treatment, considering the right ovarian tumor was the primary lesion. The patient remained alive and in good condition without any signs of recurrence 2 years after second treatment. This case suggests that S-1 therapy may be effective for patients with mullerian cancer.
No preview · Article · Apr 2011 · Gan to kagaku ryoho. Cancer & chemotherapy