Metastatic gastric cancer mimicking an advanced cervical cancer: A case report

Background: Metastasis to the uterine cervix from non-gynecologic neoplasms is rare. However, metastatic tumors sometimes precede the diagnosis of a primary tumor, and may lead to diagnosis of the primary tumor. Case: A 50-year-old woman was referred to us complaining of increasing right flank pain. Computed tomography scan demonstrated an enlarged uterus with right-sided hydronephrosis and hydroureter. Cervical cytology revealed adenocarcinoma. She was considered to have a Stage IIIB cervical adenocarcinoma. Although no cervical lesion was seen colposcopically, histopathology from biopsies of the uterine cervix revealed poorly differentiated adenocarcinoma infiltrating around the normal endocervical glands. A metastasis from the gastrointestinal tract was suspected. The patient underwent gastroscopy and was found to have Borrmann type IV gastric cancer. Biopsies confirmed a poorly differentiated adenocarcinoma with signet ring cells. Conclusion: Physicians should bear in mind that metastatic tumors may precede the diagnosis of a primary tumor and could manifest by mimicking advanced cervical cancer.

Gastric cancer; Metastasis; Uterus

[1] Kumar N.B., Hart W.R.: “Metastases to the uterine corpus from extragenital cancers. A clinicopathologic study of 63 cases”.Cancer, 1982, 50, 2163.

[2] Mazur M.T., Hsueh S., Gersell D.J.: “Metastases to the female genital tract. Analysis of 325 cases”. Cancer, 1984, 53, 1978.

[3] Piura B., Yanai-Inbar I., Rabinovich A., Zalmanov S., Goldstein J.: “Abnormal uterine bleeding as a presenting sign of metastases to the uterine corpus, cervix and vagina in a breast cancer patient on tamoxifen therapy”. Eur. J. Obstet. Gynecol. Reprod. Biol., 1999,83, 57.

[4] Tsoi D., Buck M., Hammond I., White J.: “Gastric adenocarcinoma presenting as uterine metastasis-a case report”. Gynecol. Oncol., 2005, 97, 932.

[5] Martinez-Roman S., Frumovitz M., Deavers M.T., Ramirez P.T.: “Metastatic carcinoma of the gallbladder mimicking an advanced cervical carcinoma”. Gynecol. Oncol., 2005, 97, 942.

[6] Lemoine N.R., Hall P.A.: “Epithelial tumors metastatic to the uterine cervix. A study of 33 cases and review of the literature”.Cancer, 1986, 57, 2002.

[7] Ha H.K., Baek S.Y., Kim S.H., Kim H.H., Chung E.C., Yeon K.M.: “Krukenberg’s tumor of the ovary: MR imaging features”. AJR Am. J. Roentgenol., 1995, 164, 1435.

[8] Treszezamsky A., Altuna S., Diaz L., Vighi S., Sardi J.: “Metastases to the uterine cervix from a gastric carcinoma presenting with obstructive renal failure: a case report”. Int. J. Gynecol. Cancer, 2003, 13, 555.