Carcinoma of the cervical stump: Fifty years of experience

Hellström, Ann‐Cathrin; Hellman, Kristina; Pettersson, B.; Andersson, Sonia

doi:10.3892/or.2011.1228

Cited by 11 publications

(6 citation statements)

References 6 publications

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“…Therapeutic strategies and overall prognosis do not differ to those with an intact uterus, although it is suggested that early-stage carcinoma of the cervical stump is found rarer compared to cervix carcinoma of an intact uterus [ 19 ]. Thus, it can be presumed that cervical stump cancers have a poorer prognosis due to higher stage at diagnosis compared to cervical cancer cases in patients with intact uterus [ 20 ]. Hellström et al [ 21 ] reported no poorer prognosis after radiologically treated squamous cervix carcinoma of the uterine stump compared to patients with intact uterus with an increased complication rate in stump cancer cases, presumably due to anatomic modifications in the pelvis following a LASH [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach

Andrikos¹,

Andrikos²,

Naem

et al. 2023

BMC Women's Health

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Background Advanced cancer of the cervical stump, occurring years after a laparoscopic supracervical hysterectomy (LASH), is a rare but serious clinical condition. Many patients who undergo a LASH are unaware of this possible complication. Upon diagnosis of advanced cervical stump cancer, a holistic approach including imaging, laparoscopic surgery and multimodal oncological therapy is required. Case presentation A 58-year-old patient presented to our department with the suspicion of advanced cervical stump cancer eight years after LASH. She reported pelvic pain, irregular vaginal bleedings and irregular discharge. Gynaecological examination revealed a locally advanced tumor of the uterine cervix with suspicion of infiltration of the left parametria and bladder. After thorough diagnostic imaging and laparoscopic staging, the tumor stage was determined as FIGO IIIB and the patient was treated with combined radiochemotherapy. The patient presented with tumor recurrence 5 months after the completion of therapy and she is currently being treated with multichemotherapy and immunotherapy regimens as palliative treatment. Conclusion Patients should be made aware about the risk of cervical stump carcinoma after LASH and the necessity for regular screening. Cervical cancer after LASH is often diagnosed at advanced stages and the treatment requires an interdisciplinary approach.

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Section: Discussionmentioning

confidence: 99%

Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach

Andrikos¹,

Andrikos²,

Naem

et al. 2023

BMC Women's Health

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“…Our second patient makes a convincing case for "postmenopausal" vaginal bleeding due to PV. Here, a resection of the cervical stump was recommended because of a heightened concern for stump cervical squamous or endometrial adenocarcinoma (22)(23)(24) and was avoided because of reconsideration of the findings in light of the history of PV.…”

Section: Discussionmentioning

confidence: 99%

Cervical Pemphigus Vulgaris Presenting as Postmenopausal Bleeding

Smith

Moscarelli

Panse

et al. 2020

International Journal of Gynecological Pathology

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Pemphigus vulgaris is a severe mucocutaneous blistering disease with rare genital involvement. When present, female genital involvement is typically vulvo-vaginal and associated with characteristic bullous lesions elsewhere, most commonly in the oral cavity. Postmenopausal bleeding as a symptom of pemphigus is not reported to date. We present 2 cases of pemphigus vulgaris with postmenopausal bleeding that led to significant work-up for the patients, including hysterectomy for 1 patient. The site of bleeding was established to be related to cervical involvement in 1 patient and assumed to be of cervical origin in the other. As improving treatment modalities result in long-term survival in patients with pemphigus, isolated genital relapse/recurrence of pemphigus vulgaris involving the cervix may result with symptoms not previously attributed to the disease including postmenopausal bleeding. Both gynecologists and pathologists need to be aware of this possibility to accurately label symptoms as disease related and avoid unnecessary interventions for patients.

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“…Carcinomas of the cervical stump after subtotal hysterectomy are not uncommon with an incidence of 0.1-3 %. Among these carcinomas, approximately 88 % were squamous cell carcinoma and the remaining were adenocarcinoma [ 31 , 32 ]. However, we could not find any reports on adenocarcinoma or serous EIC arising in endometriosis (adenomyotic cyst) of the cervical stump in English literature to date.…”

Section: Discussionmentioning

confidence: 99%

Serous carcinoma arising from uterine adenomyosis/adenomyotic cyst of the cervical stump: a report of 3 cases

et al. 2016

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BackgroundSerous carcinoma arising in adenomyosis and adenomyotic cyst is very rare. Only 3 serous carcinomas and 5 serous endometrial intraepithelial carcinomas (EIC) have been reported to date.MethodsWe reviewed the clinicopathological features of 2 serous carcinoma in uterine adenomyosis and 1 serous EIC in adenomyotic cyst of the cervical stump.ResultsCase 1 had an endometrial serous carcinoma in the uterine myometrium and the left ovary. A minor component of benign endometrial glands with minimal endometrial stroma was found in the uterine mass and the surrounding myometrium. Case 2 showed 3 small foci of serous carcinoma, serous EIC and endometrial glandular dysplasia (EmGD) in the adenomyosis. Scanty serous carcinoma was present in the endometrium without evidence of myometrial invasion. The eutopic endometrium in both case 1 and 2 had no evidence of neoplastic changes after complete examination. Case 3 had 3 microscopic serous EICs in the adenomyotic cysts of the cervical stump. One EIC lesion coexisted with EmGD. No cancer was found in the endocervical tube although the preoperative endocervical biopsy showed a poorly differentiated endometrioid carcinoma. Immunohistochemistry demonstrated that serous carcinoma in case 1 and EIC in all 3 cases showed a characteristic pattern of p53 and p16 over expression, high Ki67 index, and lack of WT1, ER and PR staining. EmGD in case 1 and 3 had a similar staining pattern except a lower Ki67 index and the presence of ER expression.ConclusionsWe believe that this case series may expand our recognition on serous carcinoma arising in uterine adenomyosis/adenomyotic cyst including extra-uterine spread and the potential synchronous growth of carcinomas in eutopic endometrium.

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Carcinoma of the cervical stump: Fifty years of experience

Cited by 11 publications

References 6 publications

Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach

Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach

Cervical Pemphigus Vulgaris Presenting as Postmenopausal Bleeding

Serous carcinoma arising from uterine adenomyosis/adenomyotic cyst of the cervical stump: a report of 3 cases

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