Benito Chiofalo1, Jacopo Di Giuseppe1, Lara Alessandrini2, Tiziana Perin2, Giorgio Giorda1, Vincenzo Canzonieri2, Francesco Sopracordevole3. 1. Department of Gynecologic Oncology, Centro di Riferimento Oncologico-National Cancer Institute, 33081 Aviano, Pordenone, Italy. 2. Department of Pathology, Centro di Riferimento Oncologico-National Cancer Institute, 33081 Aviano, Pordenone, Italy. 3. Department of Gynecologic Oncology, Centro di Riferimento Oncologico-National Cancer Institute, 33081 Aviano, Pordenone, Italy. Electronic address: fsopracordevole@cro.it.
Abstract
BACKGROUND: Three primary synchronous cancers in the female genital tract are extremely rare. In the literature, only four studies have described three different invasive gynecologic cancers of epithelial origin identified simultaneously in the same patient. CASE PRESENTATION: This is the first case in the literature that reports on triple primary ovarian, endometrial and endocervical cancers in a 38-year-old woman with a history of previously treated malignant disease (acute lymphatic leukemia). With a preoperative diagnosis of endocervical adenocarcinoma stage Ib1 (according to International Federation of Gynecology and Obstetrics-FIGO), as well as an adnexal mass, she underwent radical hysterectomy with bilateral adnexectomy. Pathologic examination of the surgical specimen revealed a mucinous adenocarcinoma of the cervix, an endometrioid adenocarcinoma of the uterine corpus, and a mucinous adenocarcinoma of the left ovary. Eighteen months after appropriate treatment, the patient is free of disease. CONCLUSION: The incidental diagnosis of more than one tumor is often a post-operative finding, usually with the detection of low-stage neoplasms. Multiple synchronous gynecologic cancers have a better prognosis than metastatic or advanced primitive disease. In a patient with multiple neoplasms, the prognosis is determined by the tumor with the worst prognosis.
BACKGROUND: Three primary synchronous cancers in the female genital tract are extremely rare. In the literature, only four studies have described three different invasive gynecologic cancers of epithelial origin identified simultaneously in the same patient. CASE PRESENTATION: This is the first case in the literature that reports on triple primary ovarian, endometrial and endocervical cancers in a 38-year-old woman with a history of previously treated malignant disease (acute lymphatic leukemia). With a preoperative diagnosis of endocervical adenocarcinoma stage Ib1 (according to International Federation of Gynecology and Obstetrics-FIGO), as well as an adnexal mass, she underwent radical hysterectomy with bilateral adnexectomy. Pathologic examination of the surgical specimen revealed a mucinous adenocarcinoma of the cervix, an endometrioid adenocarcinoma of the uterine corpus, and a mucinous adenocarcinoma of the left ovary. Eighteen months after appropriate treatment, the patient is free of disease. CONCLUSION: The incidental diagnosis of more than one tumor is often a post-operative finding, usually with the detection of low-stage neoplasms. Multiple synchronous gynecologic cancers have a better prognosis than metastatic or advanced primitive disease. In a patient with multiple neoplasms, the prognosis is determined by the tumor with the worst prognosis.
Authors: Ahmed Abu-Zaid; Mohannad Alsabban; Mohammed Abuzaid; Osama Alomar; Hany Salem; Ismail A Al-Badawi Journal: Case Rep Obstet Gynecol Date: 2017-08-23