A Case of Metastatic Lymph Node of Invasive Cervical Cancer Diagnosed by Endoscopic Ultrasonography-Guided Fine Needle Aspiration Biopsy

Abstract

Cervical cancer is the most common malignant gynecological cancer. The incidence and mortality of cervical cancer has been declining in developed countries, but it is still one of the most common cancers in women worldwide. Prognoses of cervical cancer are based on the stage, size, histologic grade of a primary tumor and metastasis of lymph node. CT, MRI, and 18 F-fluoro-2-deoxyglucose (FDG) PET are widely utilized and effective for detecting early recurrence in cervical cancer. The lymph node metastasis of cervical cancer begins locally and spreads distantly. Metastasis of cervical cancer has been rarely assessed by means of EUS or EUS-guided fine needle aspiration biopsy (FNAB) as a form of subepithelial lesion of stomach. A 62-year-old female was referred to the department of gastroenterology for evaluation of a mass like gastric subepithelial tumor with high uptake of 18 F-FDG in PET-CT. Four years ago, the patient underwent a total abdominal hysterectomy with bilateral salphingo-oophorectomy for invasive cervical cancer. The specimen obtained by EUS-FNAB appeared to be pus. Finally, the lesion was diagnosed as metastatic squamous cell carcinoma originated from the previous invasive cervical cancer. The patient completely recovered after systemic chemotherapy for the metastatic lesion.

Novel use of fine needle aspiration (FNA) biopsy to diagnose cervical cancer in a low‐resource setting: A case series Morovia, Liberia

“…This is the first published report on the use of FNA for diagnosing cancer from visible cervical lesions seen on speculum examination. Other reports of cervical cancer diagnosis using FNA have been limited to evaluation of metastatic sites such as the mediastinum, 19 supraclavicular nodes, 20 retroperitoneal nodes, 21 or intra‐abdominal masses 22 . Cendrowski et al 23 additionally demonstrated the upstaging of clinically staged cervical cancer IB by preoperative assessment of parametria using FNA and trans‐vaginal sonography (TVS) with 71% sensitivity and 86% specificity.…”