Abstract
Synchronous tumours of gynaecological malignancies occur rarely and most of these cases are represented by synchronous ovarian and endometrial cancer. Synchronous malignancies of cervix and ovary are rare with poor prognosis. Only few cases of synchronous cancer of cervix and ovary are found in the literature as case reports. Here, we report a case of a 63 year old patient who was diagnosed with synchronous squamous cell carcinoma of cervix and high grade serous carcinoma of ovary in which her clinical presentation, investigation and intraoperative findings were atypical. Patient presented with postmenopausal bleeding and mass per abdomen. Pipelle sampling revealed squamous cell carcinoma of cervix. Examination under anaesthesia noted endocervical growth measuring 3×4 cm with endoluminal extension into the whole endometrial cavity. Computerized tomography (CT) imaging showed left ovarian mass measuring 10.0×11.7 cm. Uterine corpus involvement in this case mislead us to the initial diagnosis of ovarian metastasis in cervical cancer. The distinct histopathological features of the ovary, cervix and endometrial lesion post operatively helped in establishing the diagnosis of two separate primaries which was synchronous cervical and ovarian cancer rather than metastatic spread of one primary malignancy.
Highlights
Synchronous gynaecological malignancies are rare with overall incidence of 0.63% [1], [2]
Low stage and low grade synchronous tumours must be distinguished from metastatic tumours for accurate management as they carry better prognosis compared to metastatic counterpart
The proportion of cases presenting with ovarian metastasis at the time of surgery ranges from 0.6-1.5% [8]
Summary
Synchronous gynaecological malignancies are rare with overall incidence of 0.63% [1], [2]. Adenocarcinoma of cervix compared to cervical squamous cell type metastasis more common to ovary with incidence of 0.6-1.5% [8]. The aim of this report is to present the case of a patient who was initially diagnosed with cervical squamous cell carcinoma with ovarian metastasis based on clinical and intraoperative findings the final diagnosis was synchronous cervical and ovarian cancer from histopathology report. Examination under anaesthesia revealed endocervical growth with uterine corpus involvement This made us to come up with impression of metastasis of cervix to ovary. Histopathology result of benign lesion of the endometrial poly and distinct histological features of cervix and ovary brought to the final diagnosis of synchronous tumour of cervix and ovary It could still be a synchronous tumour of cervical and endometrium. This is if the endometrial polyp which originally could had been a carcinomatous serous endometrial polyp with metastasis to ovary prior to initiation of neoadjuvant chemotherapy
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