Isolated ovarian metastasis in otherwise cervix-confined adenocarcinoma of the cervix: A rare clinical conundrum

IF 1.5 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2026-06-01 Epub Date: 2026-05-28 DOI:10.1016/j.gore.2026.102120

Lauren M. Lim , Sarah L. Speck , Yingao Zhang , Renata Urban , Margaret I. Liang

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引用次数: 0

Abstract

Background

Isolated ovarian metastasis in otherwise early-stage cervical cancer is an extremely rare clinical scenario. According to the 2018 International Federation of Gynecology and Obstetrics, ovarian involvement does not change staging of cervical cancer. However, ovarian metastasis is known to indicate a worse prognosis.

Case presentation

This report describes the clinical courses of two patients diagnosed with clinically early-stage adenocarcinoma of the cervix. Both patients had simple-appearing unilateral ovarian cysts, not concerning for metastasis. Each underwent primary surgical treatment, which then discovered unilateral ovarian metastasis of primary cervical cancer. Both patients were treated with adjuvant chemoradiation with cisplatin and pembrolizumab followed by pembrolizumab maintenance, per KEYNOTE A-18 as for Stage IVA disease. One patient’s tumor had PD-L1 combined positive score (CPS) < 1, while the other patient had CPS of 12 but stopped immunotherapy early due to toxicity. Patients were disease-free 15–21 months following surgery.

Conclusion

Given the limited data with this unique clinical presentation, some oncologists may choose to treat these patients as locally advanced disease, whereas others may favor treating ovarian involvement as distant metastasis. Further investigation of the best management for these patients is needed.

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孤立卵巢转移在其他宫颈局限腺癌子宫颈：罕见的临床难题

背景：孤立性卵巢转移在早期宫颈癌中是一种极为罕见的临床情况。根据2018年国际妇产科联合会（International Federation of Gynecology and Obstetrics）的数据，卵巢受累不会改变宫颈癌的分期。然而，已知卵巢转移预示着较差的预后。本报告描述了两例临床诊断为早期宫颈腺癌的患者的临床过程。两例患者均为单侧卵巢囊肿，无转移。每个人都接受了最初的手术治疗，然后发现原发性宫颈癌的单侧卵巢转移。根据KEYNOTE A-18，对于IVA期疾病，两名患者均接受顺铂和派姆单抗的辅助放化疗，随后进行派姆单抗维持。1例患者肿瘤PD-L1联合阳性评分（CPS） < 1，另1例患者肿瘤CPS为12，但因毒性而提前停止免疫治疗。术后15-21个月患者无疾病。鉴于这种独特临床表现的有限数据，一些肿瘤学家可能会选择将这些患者作为局部晚期疾病治疗，而另一些肿瘤学家可能倾向于将卵巢累及作为远处转移治疗。需要进一步研究这些患者的最佳治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.