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194 Small adenocarcinoma of the cervix with single giant ovarian metastasis: case report
  1. L Micelli,
  2. F Souza Nobrega,
  3. JP Mancusi de Carvalho,
  4. ML Nogueira Dias Genta,
  5. D Sampaio AM Piato,
  6. G Miglino Suárez and
  7. J Paula Carvalho
  1. Cancer Institute of the State of São Paulo, Gynecologic Oncology, São Paulo, Brazil


Objectives To demonstrate the importance of ovarian evaluation in cases of adenocarcinoma of the cervix, since the ovaries may be the only site of metastasis.

Methods Analysis of patient medical record.

Results A 56-year-old female presented to the outpatient clinic with increased abdominal volume. Gynecological examination revealed a small exophytic lesion of 2cm in the endocervical canal, without vaginal or parametrial involvement. Biopsy of the lesion resulted in adenocarcinoma with papillary and glandular components and immunohistochemistry proving primary tumor of the uterine cervix. The patient underwent a pelvic computed tomography. Bilateral ovarian masses with solid components and ascites with no signs of carcinomatosis were observed. The patient was submitted to radical hysterectomy with bilateral salpingoophorectomy, pelvic lymphadenectomy, omentectomy, appendectomy and multiple peritoneal biopsies. Anatomopathological analysis resulted in usual endocervical adenocarcinoma with intestinal pattern in the cervix and cervical metastasis in both ovaries. All surgical margins were free of disease.

Conclusions This case was an unusual presentation of cervical cancer that showed the possibility of single ovarian metastasis without any other tumor involvement. The importance of adequate preoperative ovarian evaluation is highlighted, raising the question whether there is a role for bilateral oophorectomy in all cases of adenocarcinoma of the cervix.

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