Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix
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CASE REPORT
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix Rani Kanthan*, Jenna-Lynn B Senger, Dana Diudea
Abstract Introduction: Pulmonary metastasis presenting as lymphangitic carcinomatosis arising from squamous cell carcinoma (SCC) of the cervix is a rare event. Poorly represented in the literature, this event is associated with a) difficulty in accurate diagnosis, b) grave prognosis, and the c) lack of recognized predisposing risk factors. Case Report: A 50 year-old female presented at our practice with a three-month history of a productive cough associated with dyspnoea and shortness of breath. A chest x-ray and computed tomography (CT) scan revealed multiple bilateral patchy areas with subsegmental atelectasis in both lungs which was investigated with a bronchoscopy, left thoracoscopy, and a left lung biopsy. Pathological examination of the wedge biopsy of the left upper lobe revealed neoplastic sheets of cell disturbed along the septal vessels, perivascular/peribronchial lymphatics, and the subpleural lymphatics. This lymphangitic carcinomatosis was confirmed to be metastatic from SCC of the cervix that had been diagnosed and treated two years ago. She was treated with systemic Carbo/Taxol chemotherapy and corticosteroids as a palliative measure. Despite temporary improvement, she died 13 months later. Conclusion: Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic SCC of the cervix. As clinical presentations including radiographic imaging mimics other pulmonary entities, accurate diagnosis remains a challenge. Increased clinical awareness of such patterns of metastases in cervical cancer supported by accurate pathological diagnosis is imperative to guide appropriate therapy in these patients.
Introduction Despite advances in screening, cervical cancer remains a significant cause of mortality and morbidity [1]. Cancer of the cervix often metastasizes to nearby organs, and extrapelvic spread is rare. Pulmonary metastasis from carcinoma of the uterine cervix, though uncommon, has been reported in 2.2-9.1% of all cervical cancers [2]. The mean detection interval of pulmonary metastases from the initiation of primary treatment ranges from 2 to 46 months [2]. Histologically, patients with adenocarcinoma and undifferentiated carcinoma of the cervix have higher incidences of pulmonary metastases [2]. Lymphangitic carcinomatosis (LC) secondary to carcinoma of the cervix is exceedingly rare and associated with a grave prognosis with limited survival from 17 days to 24 months [3]. The common primary carcinomas associated with LC are breast, larynx, prostate, thyroid, gallbladder, * Correspondence: [email protected] Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon SK, Canada
stomach, and pancreas [3,4]. To the best of our knowledge, this lesion has not been reported in the published English literature for the past five years (last report September 2004
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