RESUMO
Carcinoma of cervix usually spreads contiguously to the adjacent organs, by lymphatics to the pelvic and para-aortic lymph nodes and by hematogenous route to distant organs. The common sites of distant metastasis are lung, supraclavicular lymph nodes, liver, and bones. The brain is a rare site of metastasis. We report here a rare case of a 72-year-old woman with carcinoma of cervix, FIGO stage IIA, who developed metastases to the brain.
Assuntos
Adenocarcinoma/secundário , Neoplasias Encefálicas/secundário , Neoplasias do Colo do Útero/patologia , Idoso , Feminino , Humanos , Estadiamento de NeoplasiasRESUMO
A rare case of an advanced primary broad ligament carcinoma is discussed, with a review of the literature regarding its incidence, presentation and management. This patient showed a complete response to adjuvant cisplatin-based chemotherapy following panhysterectomy and is presently without any evidence of disease, 15 months after completion of her treatment.
Assuntos
Ligamento Largo , Cistadenocarcinoma Papilar/cirurgia , Neoplasias dos Genitais Femininos/cirurgia , Antineoplásicos/uso terapêutico , Quimioterapia Adjuvante , Cisplatino/uso terapêutico , Cistadenocarcinoma Papilar/diagnóstico por imagem , Cistadenocarcinoma Papilar/tratamento farmacológico , Diagnóstico Diferencial , Feminino , Neoplasias dos Genitais Femininos/diagnóstico por imagem , Neoplasias dos Genitais Femininos/tratamento farmacológico , Humanos , Histerectomia , Pessoa de Meia-Idade , Fotomicrografia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
BACKGROUND: The advantage of 4-field radiation to the pelvis is that the use of lateral portals spares a portion of the small bowel anteriorly and rectum posteriorly. The standard lateral portals defined in textbooks are not always adequate especially in advanced cancer cervix. METHODS: An analysis was done to determine adequacy of margins of standard lateral pelvic portals with CECT defined tumor volumes. The study included 40 patients of FIGO stage IIB and IIIB treated definitively for cancer cervix between 1998 and 2000. An inadequate margin was defined if the cervical growth and uterus were not encompassed by the 95% isodose. RESULTS: An inadequate posterior margin was common with bulky disease (P = 0.06) and with retroverted uterus (P = 0.08). Menopausal status, FIGO stage, associated myoma, and age were of no apparent prognostic significance. Bulk retained significant on multivariate analysis. An inadequate anterior margin was common in premenopausal (P = 0.01); anteverted uterus (P = 0.02); associated myoma (P = 0.01); and younger patients (P = 0.03). It was not influenced by bulk or stage. Menopausal status and associated myoma retained significant on multivariate analysis. CONCLUSION: Without the knowledge of precise tumor volume, the 4-field technique with standard portals is potentially risky as it may under dose the tumor through lateral portals and the standard AP/ PA portals are a safer option.