Gastric cancer in a 22-year-old woman with metastasis to the cervix: a case report and literature review

Abstract

Metastatic cervical cancer of gastric cancer is rare, especially in young patients with cervical lesions as the primary manifestation and diagnosed at the same time with gastric cancer. We reported a 22-year-old woman diagnosed as gastric cancer with no gastrointestinal symptoms. But her primary complaint was menstrual dysregulation and genital bleeding after intercourse. In the beginning, due to no abnormalities were found upon cervical liquid-based cytology or human papilloma virus (HPV) typing, the patient was diagnosed with functional uterine bleeding and was given Diane-35 oral treatment. After treatment, the patient’s symptoms did not improve, and when she went to the doctor again, colposcopy was performed, and cervical biopsy indicated a poorly differentiated mucinous adenocarcinoma, with signet ring cell carcinoma differentiation in some areas. The results of immunohistochemistry analysis suggested metastatic cancer from a digestive system tumor. Then the pathological results of a gastric mucosa multipoint biopsy showed poorly-differentiated mucinous adenocarcinoma and signet ring cell carcinoma were found. After diagnosis, the patient began chemotherapy. During the sixth cycle of chemotherapy, the patient developed Intracystic hemorrhage from metastatic ovarian lesions, and emergency bilateral salpingo-oophorectomy was performed. The patient is in a stable condition and is currently undergoing chemotherapy. To the best of our knowledge, this is the youngest case identified so far. Although metastatic cervical cancer is rare, especially diagnosed at the same time with gastric cancer, clinicians should be aware that it can occur in very young patients.