Cutaneous vulvar metastases of cervical cancer 9 years after radical surgical excision followed by radiochemotherapy – case report
Affiliation and adress for correspondence

1 Oddział Ginekologii i Położnictwa w Ustce, Wojewódzki Szpital Specjalistyczny w Słupsku. Ordynator: dr n. med. Adam Cieminski
2 Katedra i Zakład Patomorfologii, Gdański Uniwersytet Medyczny, ul. Dębinki 7, 80-211 Gdańsk. Kierownik: prof. dr hab. n. med. Wojciech Biernat
Correspondence to: Oddział Ginekologii i Położnictwa w Ustce, Wojewódzki Szpital Specjalistyczny w Słupsku, ul. Mickiewicza 12, 76-270 Ustka,
tel.: 59 815 42 20
Source of financing: Department own sources

CURR. GYNECOL. ONCOL. 2010, 8 (4), p. 244-250
ABSTRACT

Cutaneous metastases of cervical cancer are extremely rare, even in late stage disease. They usually appear up to 10 years after first diagnosis in about 0.1-2.0% of all cases. They most frequently appear in the abdomen, vulva and anterior chest, usually as an isolated lesion; multifocal lesions are rare. We present a case of an isolated cutaneous vulvar metastasis of an adenosquamous cervical cancer, developing 9 years after radical surgical treatment followed by radiotherapy (tele- and brachytherapy), 8 years later undergoing surgical excision of recurrent tumor with subsequent chemotherapy. Histological study of both primary cervical and secondary cutaneous lesions excluded vulva as place of origin, confirming metastatic character of adenosquamous tumor. Upon surgical excision of the metastasis, the patient received adjuvant chemotherapy. Unfortunately, rapid progression followed in spite of treatment instituted, as confirmed by imaging studies (multiple round focal lesions in the lungs and liver, bilaterally enlarged inguinal lymph nodes consistent with secondary tumor seeding seen on magnetic resonance imaging and a local intrapelvic lesion visualized by computed tomography). Cutaneous metastases of cervical cancer are considered a ominous prognostic factor, associated with faradvanced terminal phase of the disease or local recurrence with multiple distant metastases, as confirmed by the present case. In this setting, treatment is palliative only, consisting in chemotherapy, radiotherapy and surgical excision of the lesion, used either in combination or alone. Mean survival since diagnosis is only 3-4 months and only about 20% of the patients survive over 1 year.

Keywords: cervical cancer, cutaneous metastases, diagnosis, treatment, disease progression