A Case Of Two Synchronous Tumour Of Different Histology - Advanced Cervical Adenocarcinoma With Borderline Mucinous Ovarian Tumour In A 22 Year Old Virgin.

Abstract

We report a case of synchronous cervical adenocarcinoma with borderline mucinous ovarian tumourin a 22 year old virgin who presented with prolonged bleeding and dysmenorrhoea of four months duration. A transabdominal ultrasound demonstrated fluid in the endometrial cavity. This was confirmed by MRI pelvisrevealing adistended endometrial cavity with cervical stenosis. Evacuation revealed hematometra and the post evacuation uterine cavity is empty. She was discharged and subsequently presented at three months with acute urinary retention and heavy bleeding. A CT pelvisshowed complex bilateral ovarian cyst with minimal ascites, an enlarged paraaortic node at L2 and hematometrawith cervical stenosis. An exploratory laparotomy was performed with cystectomy, supracolicomentectomy with uterine and cervical biopsy. The histopathology shows bilateral borderline mucinous tumor of the ovary with metastatic omental nodules and primary well differentiated adenocarcinoma of the cervix. The subsequent CT thorax revealed metastatic pulmonary nodules. In view of advanced cervical adenocarcinoma, she was advised palliative chemotherapy with carboplatin and paclitaxel for six cycles. She has currently completed one cycle of chemotherapy. Conclusion:This case is one of the rare presentations of synchronous tumours of different histology with primary cervical adenocarcinoma and bilateral borderline ovarian tumour occurring in a virgin with atypical clinical presentation and rapid progression.