Diagnostic challenges and individualized treatment of cervical adenocarcinoma metastases to the breast:A case report  

作　　者：Allison Akers Susan Read John Feldman Casey Gooden Diana P English 

机构地区：[1]Department of Obstetrics and Gynecology,University of South Florida,Tampa,FL 33606,United States [2]Department of Gynecologic Oncology,Sky Ridge Medical Center,Lone Tree,CO 80124,United States [3]Department of Radiology,University of South Florida,Tampa,FL 33606,United States [4]Department of Pathology,University of South Florida,Tampa,FL 33606,United States

出　　处：《World Journal of Clinical Cases》2024年第2期412-417,共6页世界临床病例杂志

摘　　要：BACKGROUND Cervical cancer is a rare primary tumor resulting in metastases to the breast with few cases reported in literature.Breast metastases are associated with poor prognosis.The following case highlights the diagnostic challenges associated with metastatic cervical cancer to the breast along with individualized treatment.CASE SUMMARY A 44-year-old G7P5025 with no significant past medical or surgical history presented with heavy vaginal to an outside emergency department where an exam and a pelvic magnetic resonance imaging showed a 4.5 cm heterogenous lobulated cervical mass involving upper two thirds of vagina,parametria and lymph node metastases.Cervical biopsies confirmed high grade adenocarcinoma with mucinous features.A positron emission tomography/computed tomography(PET/CT)did not show evidence of metastatic disease.She received concurrent cisplatin with external beam radiation therapy.Follow up PET/CT scan three months later showed no suspicious fluorodeoxyglucose uptake in the cervix and no evidence of metastatic disease.Patient was lost to follow up for six months.She was re-imaged on re-presentation and found to have widely metastatic disease including breast disease.Breast biopsy confirmed programmed death-ligand 1 positive metastatic cervical cancer.The patient received six cycles of carboplatin and paclitaxel with pembrolizumab.Restaging imaging demonstrated response.Patient continued on pembrolizumab with disease control.CONCLUSION Metastatic cervical cancer to the breast is uncommon with nonspecific clinical findings that can make diagnosis challenging.Clinical history and immunohistochemical evaluation of breast lesion,and comparison to primary tumor can support diagnosis of metastatic cervical cancer to the breast.Overall,the prognosis is poor,but immunotherapy can be considered in select patients and may result in good disease response.

关 键 词：Cervical adenocarcinoma Breast metastases IMMUNOTHERAPY Pembrolizumab CARBOPLATIN PACLITAXEL Case report 

分 类 号：R737.9[医药卫生—肿瘤] R737.33[医药卫生—临床医学]