Carcinoma metastatic to the uterine cervix

Cervical cytology is mainly used for the screening and detection of early cervical cancers and its precursors. Rarely, detection of malignant cells in cervical cytology specimens is the first manifestation of an extrauterine (EU) malignancy. We report a case of a 49-year-old female in which adenocarcinoma initially diagnosed on routine, liquid-based cervical cytology led to the detection of a primary lung cancer.

Metastases to the female genital tract from extragenital cancers are uncommon. The ovaries are most often affected with the breast and gastrointestinal tract being the most common sites of the primary malignancy. Metastases to the uterus from extragenital cancers are significantly rarer than metastases to the ovaries and in the majority of cases the ovaries are also involved. A case of metastases restricted to the uterine corpus, cervix and vagina from breast carcinoma, without involvement of the ovaries, is described. The patient who had been on tamoxifen therapy presented with postmenopausal bleeding. The diagnosis of uterine metastases was established during endometrial ablation and confirmed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. This case illustrates that abnormal uterine bleeding in a breast cancer patient, regardless of whether she is receiving or not receiving tamoxifen, should always alert the physician to consider the possibility of uterine metastases from breast carcinoma.

Biopsy of the uterine cervix from a 46-year-old woman who suffered from epigastric pain and weight loss showed metastatic adenocarcinoma. The primary site of the tumor was the stomach. At laparotomy, disseminated adenocarcinoma on the peritoneum and Krukenberg's tumor in the right ovary were found. A palliative partial gastrectomy, resection of the right ovary, and postoperative chemotherapy were performed. The possible mechanism of metastasis of extragenital cancer to the uterus is discussed.

Secondary carcinoma of the cervix is uncommon. A patient with a history of ovarian carcinoma had an abnormal cervical smear and colposcopy was performed. Colposcopy and directed biopsy led to the diagnosis of ovarian cancer which had spread to the cervix. The unusual colposcopic features which allowed a clinical diagnosis are correlated with histopathology and the findings discussed.

Six cases of metastatic carcinoma of the uterine cervix are reported. Of these, five originated from the stomach and one from the colon. The histopathologic features of metastatic carcinoma of the cervix uteri are presented and the route of the metastasis is discussed.