Metastatic Uterine Cervical Cancer Originating in the Lung: A Case Report

Abstract

We report a case of primary pulmonary adenocarcinoma which metastasized to the uterine cervix. A 69-year-old postmenopausal Japanese female was admitted to our hospital because of general fatigue and atypical genital bleeding. Four years before, she had undergone video-assisted thoracoscopic right upper lobectomy, for primary lung cancer (adenocarcinoma), stage IIIb, pT3N1M0. Gynecologic investigation showed a cauliflower-like tumor in the uterine cervix and parametrial invasion towards the bilateral pelvic wall. Metastasis of extragenital carcinoma to the cervix uteri is rare. Most such reported cases originated in the breast and gastrointestinal tract. In this case, cervical biopsy specimens were revealed to be adenocarcinomatous, similar in pathological features to the previously resected lung cancer. Immunohistochemical staining was positive for thyroid transcription factor-1 and pulmonary surfactant apoprotein A and negative for CA125 and thyroglobulin. Although rare, the respiratory tract should be considered as a possible primary site of uterine cervical metastatic carcinoma.

Adenocarcinoma metastatic to the uterine cervix: A case series

“…In order to explain the low incidence of cervical metastases, we postulated that the characteristics of small organ size, in addition to reduced blood flow and distal circulation, as well as the organ's abundant content of fibrous tissue, make the uterine cervix a medium that is scarcely favorable for the propagation of malignant cells 4 . In spite of its low frequency, the international literature registers multiple reports of isolated cases and small series of cases that describe the clinical behavior of metastasis to the uterine cervix and its relationship with diverse primary neoplasms such as lung cancer, 5,6 gall bladder cancer, 7,8 kidney cancer, 9,10 melanoma, 11 gastrointestinal stromal tumor 12 and transitional cell carcinoma, 13 among others. Notwithstanding the diversity of primary extragenital neoplasms that may metastasize to the cervix, the largest series analyzed led us to believe that the most frequent primary neoplasms derive from the ovary in 42.1% of reports, gastrointestinal tract in 19.8%, uterine tube in 6.1%, breast in 4.5% and primary peritoneum in 3.0% 3 .…”

Lung adenocarcinoma with EGFR gene mutation metastatic to the uterine cervix

“…For example, in this report, 4 years after the patient's right upper lobe resection, primary lung adenocarcinoma was found to metastasize to the uterine cervix, and the patient selected first-line chemotherapy with carboplatin and paclitaxel. [ 8 ] Currently, detecting the driver genes of advanced NSCLC is a necessary measure that is very important for the treatment and monitoring of tumors. [ 9 , 10 ] For example, in this report, ALK rearrangement was detected in a patient with simultaneous cervical and mammary gland metastases from lung adenocarcinoma between the primary and metastatic cancers.…”

Bilateral ovarian serous cystadenocarcinoma metastasizing to cervix: a rare case report

“…3 But hematogenous spread of tumor emboli leading to cervical metastasis has been detected in cases of ovarian malignancy and cancer of stomach, gall bladder, pancreas, breast and lung. [4][5][6][7] Cervical metastasis in the above malignancies always indicates the advanced stage of tumor and multiorgan involvement, indirectly stating poor prognosis.…”