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190 A case report: advanced cervical cancer diagnosed with acute peritonitis and emergent surgery with omentum metastasis
  1. O Masari1,
  2. Y Onishi2,
  3. M Minematsu2 and
  4. S Natsuaki2
  1. 1Fukuoka Tokusyukai Hospital-, Obstetrics and Gynecology, Fukuoka, Japan
  2. 2Fukuoka Tokusyukai Hospital, Obstetrics and Gynecology, Fukuoka, Japan


Objectives Advanced cervical cancer are often diagnosed with atypical genital bleeding, urological symptoms, distant metastasis. We report a case of stage IV uterine cervical cancer, which was found after acute surgical operations suspected bowel perforation.

Methods A 37-years-old woman(G1-P1) visited the ER department of our hospital because of upper abdominal pain, she had peritoneal irritation sign. Abdominal ultrasound showed swelling appendicitis, para-aortic lymph nodes, and ileocecal nodules. The computed tomographic scanning showed thickening rectal mucosa. Our surgeons suspected carcinomatous peritonitis by appendix tumor and gastrointestinal perforation. And on that day,surgeons did emergent laparoscope, findings suggested cancerous peritonitis with stage IV rectal cancer, but the final pathological diagnosis of appendix and omentum was squamous cell carcinoma. So, we suspected metastasis from uterine cervical squamous cancer.

Results We had confirmed swelling cervical tumor and infiltration to rectal, and she was diagnosed stage IV cervical cancer. She has had a concurrent chemoradiotherapy (CDDP), hyperthermia, and hyperbaric oxygen therapy. Now her abdominal pain is improved. She had no grade 4 toxicity rectal perforation, her PS is 0 and she had been continuing carboplatin, paclitaxel and Bevacizumab once a month.

Conclusions Even she had checked up of uterine cervical cancer during the second pregnancy, and it was normal. It is rare a cervical cancer causes omental metastasis, but we should suspect cervical cancer even if there is no genital bleeding. And we find it may be important to check up the cervical cancer for one month from the delivery. In Japan, the percent of the cervical cancer screening is low and no political vaccination system. Therefore we should consider a new system that can check regularly for mothers they should be very busy for child care.

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