Article Text
Abstract
Introduction/Background Multiple primary malignant neoplasms (MPMN) are defined as two or more primary malignancies diagnosed in an individual. Synchronous gynecological malignancies are rarely encountered, with a growing tide to recognize these primary tumors. Although synchronous ovarian and cervical cancer is rarely encountered, patients might benefit from early identification and subsequent debulking surgery with curative intent.
Methodology The main objective of this report is to present the clinical history, physical examination, and intraoperative and microscopic findings of the case. This is a case of a 48-year old, multigravid, who presented with a 3-year history of gradual abdominal enlargement associated with profuse vaginal bleeding. On initial transabdominal and transvaginal ultrasound, the cervix was converted to a 7.5 x 8.0 x 6.4 cm irregular solid mass with extension to the vagina, bilateral parametria and pelvic sidewalls. Within the abdominopelvic cavity was an irregular solid mass measuring 19.0 x 19.0 x14.6 cm.
Results Cervical punch biopsy of the mass showed invasive carcinoma with glandular features with immunohistochemistry (IHC) studies showed positive for p16 and weak focal positive for Estrogen receptor. She then underwent exploratory laparotomy, peritoneal fluid cytology, resection of ovarian malignancy, with infracolic omentectomy and targeted biopsy of the left and right paracolic area. Histopathology showed Mucinous Adenocarcinoma. Peritoneal fluid cytology was suspicious for malignancy. Final staging according to FIGO was Cervical carcinoma stage IVA and Mucinous Ovarian carcinoma stage IC3.
Conclusion The presence a cervical mass with strong IHC stain for p16 pointing towards an HPV-related carcinoma and a separate pathology of a mucinous adenocarcinoma of the right ovary gives us a diagnosis of a multiple primary malignant tumors. Patient has remained in follow up and currently on systemic chemotherapy with Carboplatin and Paclitaxel.
Disclosures No disclosures.