Stage IA1 HPV-associated cervical squamous cell carcinoma metastasizing to ovary by special pathway: a case report and literature review

Abstract

Background As the leading cancer of the female reproductive tract, it is not uncommon for human papilloma virus (HPV)-associated cervical squamous cell carcinoma (HPV-CSCC) to metastasize to pelvic organs and lymph nodes in advanced stages. However, herein, we present a rare case in which superficial invasive HPV-CSCC metastasized to the unilateral ovary as a large mass by spreading directly through the endometrium and fallopian tubes and lymph-vascular space invasion. The case is so unexpected that the misdiagnosis most likely could be proceeded as a primary ovarian cancer. Case presentation A 58-year-old postmenopausal woman presented vaginal bleeding for more than 4 months, never received hormonal treatment and had no family history of malignant diseases. Routine ultrasound revealed a 12 × 10 × 10 cm right ovarian mass. Intraoperative frozen section was diagnosed as a borderline Brenner tumour with local highly suspected invasive carcinoma. Accordingly, omentectomy surgery then occurred. Unbelievably, by observation under a microscope, immunohistochemistrial staining, and HPV RNA scope, we found that the carcinoma originated from the uterine cervix. In the uterine cervix, stage IA1 superficial invasive squamous carcinoma was found, and the carcinoma directly spread to the endometrium and bilateral fallopian tube, was planted into the right ovary and eventually grew as a large mass. Moreover, lymph-vascular space invasion (LVSI) was also discovered. To date, the patient has been given 6 cycles of chemotherapy and has experienced no recurrence. Conclusions The diagnosis of superficial invasive cervical squamous cell carcinoma metastasizing to the ovary is very challenging for pathological doctors, especially in intraoperative consultations.

ALKBH5 inhibits the SIRT3/ACC1 axis to regulate fatty acid metabolism via an m6A‐IGF2BP1‐dependent manner in cervical squamous cell carcinoma

“…Invasion and metastasis are the most crucial malignant behaviours of malignancies 3 . Human papillomavirus (HPV)‐related CESC often metastasizes to lymph or pelvic organs at advanced stages, posing a greater risk to women's health worldwide 4 . Therefore, new treatment targets need to be identified.…”

“…3 Human papillomavirus (HPV)-related CESC often metastasizes to lymph or pelvic organs at advanced stages, posing a greater risk to women's health worldwide. 4 Therefore, new treatment targets need to be identified. N6 methyladenine (m6A) is the most common, abundant and conserved internal modification in eukaryotic RNAs 5 and is involved in modulating tumour progression.…”