Background: Female genital tract synchronous primary tumors are highly uncommon. Synchronous tumors affecting both the endometrium and the cervix are uncommon. We discuss a rare instance of a 71-year-old woman with uterine endometrioid adenocarcinoma and squamous cell carcinoma (SCC) of the cervix.
Case report: A 71-years old unmarried woman presented with postmenopausal bleeding for two months. Per speculum examination showed a tiny growth at the external os. Rectovaginal examination revealed ballooned up cervix with growth ~4-5cm, bulky uterus ~8 weeks in size, normal bilateral parametria, and rectal mucosa. MRI revealed a mass in the uterus involving the cervix and lower uterine segment with enlarged bilateral internal iliac lymph nodes. Endometrial biopsy was reported as a poorly differentiated carcinoma. She underwent radical hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic lymph node dissection, para-aortic lymph node dissection, and infracolic omentectomy. Final histopathology revealed the synchronous occurrence of primary neoplasms of SCC of the cervix (stage Ib3) and endometrioid adenocarcinoma endometrium (stage Ib). She received adjuvant radiation therapy and was clinically disease-free 26 months post-surgery.
Conclusion: Synchronous malignancies of the endometrium and cervix are rare. Knowledge of synchronous primaries' occurrence is needed to plan appropriate adjuvant treatment. Adjuvant treatment is based on the stage of individual primaries. The presentation stage and extent of the disease determine the prognosis of the patients.
Key words: synchronous malignancies, squamous cell carcinoma, endometrioid adenocarcinoma, cervix
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