Rare Case Of Uterine Cervix Lymphoma With Spontaneous Regression: Case Report
Desana, B., Balbo Mussetto, A., Macera, A., Mariani, L., De Rosa, G., & Cirillo, S. (2021). Rare case of uterine cervix lymphoma with spontaneous regression: Case report. The journal of obstetrics and gynaecology research, 47(2), 807–811. https://doi.org/10.1111/jog.14562
View Original Source →Abstract
Primary malignant lymphoma rarely occurs in the female reproductive tract, because of that they are often misdiagnosed. Lymphoma spontaneous regression is even rarer, but it is possible behavior of this disease. A case of 54-year-old female patient with a primary diffuse large B-cell lymphoma of the cervix is presented. First assumption was sarcoma or atypical adenocarcinoma; biopsies have been inconclusive and, after a partial spontaneous regression, diagnosis of lymphoma was possible only after surgery. The diagnosis was a real challenge for clinicians, radiologists and pathologists for both localization and behavior. Difficulties in diagnosis led to an over-treatment: a laparotomic bilateral hysteron salpingectomy with lymphadenectomy was performed, while chemotherapy alone would have been the right approach. Considering that prognosis and treatment of primary malignant lymphoma of the cervix are completely different than those of other malignant tumors of the uterus, this disease should be considered in the differential diagnosis.
Case Details
Disease Location
Cervix
Personal Characteristics
54-year-old woman in menopause since 3 years, with two regular pregnancies (one spontaneous birth and a cesarean section)
Clinical Characteristics
Trans-vaginal ultrasound revealed the presence of an endocervical lesion without a clear mucosal involvement. Several suspicious lymph nodes and second-degree hydroureteronephrosis on the right ureter were also recorded. CT scan confirmed the uterus enlargement with incarceration of the right ureter determining hydroureteronephrosis and loco-regional lymph nodes involvement. Mr showed an extended lesion involving the stroma circumferentially with no involvement of the endocervix biopsy was performed with an inconclusive report. After 3 months, a third mr showed a slight increase of the residual node (from 10 mm to 15 mm). The patient underwent laparotomic bilateral hysteron salpingectomy with lymphadenectomy. The macroscopic assessment revealed a single node on the posterolateral wall, without mucosal involvement. Definitive histological report described a primary diffuse large b-cell lymphoma of the cervix. The patient started a six-cycle r- chop protocol.
Remission Characteristics
After 15 days, a new biopsy was scheduled, but the lesion was no longer recognizable at the us examination, except for a 10 mm residual nodule
Treatment & Mechanisms
Proposed Remission Mechanisms
Regression was likely triggered by the trauma- tism of the biopsy.
Clinical Treatment
Biopsy