Journal of Postgraduate Medicine
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Year : 1989  |  Volume : 35  |  Issue : 3  |  Page : 178-9  

Epithelial ovarian cancer following cure of cervical carcinoma (a case report).

BS Charak, PM Parikh, SH Advani 
 

Correspondence Address:
B S Charak


Abstract

A case of patient developing epithelial ovarian cancer 15 years after carcinoma of cervix treated successfully with radiotherapy, is reported. The patient has shown good initial response to chemotherapy and surgery.



How to cite this article:
Charak B S, Parikh P M, Advani S H. Epithelial ovarian cancer following cure of cervical carcinoma (a case report). J Postgrad Med 1989;35:178-9


How to cite this URL:
Charak B S, Parikh P M, Advani S H. Epithelial ovarian cancer following cure of cervical carcinoma (a case report). J Postgrad Med [serial online] 1989 [cited 2022 May 28 ];35:178-9
Available from: https://www.jpgmonline.com/text.asp?1989/35/3/178/5693


Full Text



 INTRODUCTION



The ovarian tumours have a high incidence in women with Peutz-Jeghers syndrome and in those on anticonvulsant therapy; however multiple primary tumours of the female reproductive organs are uncommon.[5] We report here a case who developed an ovarian cancer fifteen years after a cervical carcinoma.

 CASE REPORT



A 42 year old female presented to this hospital in July 1972 with history of irregular bleeding and occasional discharge per vaginum for 4 months. Physical examination of the patient revealed a small, friable growth (2 can x 2 cm) over the anterior part of cervix. Biopsy of the lesion revealed moderately differentiated carcinoma; it was infiltrating the muscle coat and occasional lymphatics showed tumor emboli. The patient was treated with radiotherapy: 49 Gy in 20 fractions over 29 days. She remained well and asymptomatic till March 1987 when she developed a lump in the abdomen and ascites. Exploratory laparotomy revealed bilateral ovarian tumors involving the tubes, omentum and urinary bladder. Radical surgery was not possible; biopsy of the growth from ovaries revealed well differentiated papillary adenocarcinoma with invasion of the stroma.

The patient was treated with three cycles of 4 weekly chemotherapy with cisplatinum, adriamynin and cyclophosphamide; this was followed by debulking surgery (bilateral salpingooophorectomy, hysterectomy and omentectomy). She was given 3 more cycles of chemotherapy after surgery. The patient has shown good response and clinically there is no evidence of disease at the time of reporting i.e. 18 months after the diagnosis of ovarian cancer.

 DISCUSSION



The incidence of secondary malignancies especially leukemias after successful treatment of various cancers has increased reflecting the long term complications of the therapeutic modalities as well as the excessive proneness of these patients to multiple neoplasia. The incidence of multiple primary malignant tumours in gynaecology has been reported to be 3.15%. These tumours can be synchronous or metachronous.[1] The origin of such tumours is in dispute. Some authors postulate an embryological origin both in the upper and lower tracts predisposing histologically different and mature organs to respond to specific carcinogenic or hormonal stimuli.[2],[3],[6] In our patient, a similar situation existed but the tumours had arisen after a long interval. Since prior radiotherapy has rarely been associated with increased incidence of second gynaecologic malignancy[4] the development of ovarian cancer may not be related to the previous radiation therapy in this patient. It may just reflect the biological behaviour of the patient developing multiple cancers in a life time. Usually the therapy-related tumours respond poorly to treatment. However, this patient has shown good initial response to chemotherapy and surgery. Long term follow-up of this patient will be of interest both in observing for a relapse of ovarian tumour and development of secondaries again.

References

1Day, J . C.: The second primary malignant tumor in gynecology. A review of literature and a series presentation. Amer. J. Obstet. & Gynaecol., 75: 976-982, 1958.
2Hansen, L. H. and Collins, C. G.: Multicentric squamous cell carcinomas of the lower female genital tract. Eleven cases with epidermoid carcinoma of both vulva and cervix. Amer. J. Obstet. & Gynaecol., 98: 982-986, 1967.
3Milano, C. T., Deppe, G., Deligdisch, L. and Cohen, C. J.: Multiple primary neoplasms of the upper female genital tract. Gynaecol. Oncol., 9: 120-124, 1980.
4Rose, P. G., Herterick, E. E., Boutselis J. G., Moeshberger, M. and Sachs, L.: Multiple primary gynecologic neoplasms. Amer. J. Obstet. & Gynaecol., 157: 261-267, 1987.
5Schweisguth, O., Gerard-Marchant, R. avid Plainfosse, B.: Bilateral nonfunctioning thecoma of the ovary in epileptic children under anticonvulsant therapy. Acta Paediatr. Scand., 60: 6-10, 1971.
6Woodruff, J. D. and Julian, C. G.: Multiple malignancy in the upper genital canal. Amer. J. Obstet. & Gynaecol. 103: 810-822, 1969.

 
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