Solitary Metastasis in the Tibia as a Feature of Primary Squamous Vaginal Carcinoma: A Case Report

Autor: Pavić Mamula, Jelena, Tkalčić, Lovro, Miletić, Damir, Veljković Vujaklija, Danijela
Jazyk: chorvatština
Rok vydání: 2023
Předmět:
Zdroj: Medicina Fluminensis
Volume 59
Issue 2
ISSN: 1847-6864
1848-820X
Popis: Cilj: Primarni karcinom vagine vrlo je rijedak, čini oko 3 % svih ginekoloških tumora. Solitarne metastaze u kosti aksijalnog skeleta iznimno su rijetke, sa svega nekoliko prikazanih slučajeva. U svrhu dokumentiranja i diskusije prikazujemo iznimno rijedak slučaj izolirane metastaze skvamoznog karcinoma vagine u tibiji. Prikaz slučaja: Prikazujemo slučaj žene u dobi od 44 godine kod koje je u lipnju 2015. dijagnosticiran skvamozni karcinom vagine. Računalna tomografija toraksa, abdomena i zdjelice nije pokazala udaljene metastaze. Liječena je intersticijalnom brahiterapijom i konkomitantnom kemoradioterapijom. U ožujku 2016. zaprimljena je u našu bolnicu zbog otoka i bolova desne potkoljenice. U anamnezi nije bilo podatka o traumi i standardni radiogrami bili su normalni. Dva mjeseca kasnije, nakon daljnje progresije bolova, standardni radiogrami pokazali su intramedularnu permeativnu koštanu leziju i destrukciju kortikalne kosti dijafize tibije uz otok okolnih mekih tkiva. MR i biopsija širokom iglom potvrdila je metastazu karcinoma vagine koja sadrži tumorske stanice identične primarnom tumoru. Pacijentica je liječena radioterapijom i kemoterapijom. Usprkos svim postupcima liječenja, bolest je u idućem periodu napredovala s brojnim koštanim metastazama te, u konačnici, metastazama pluća i mozga. Zaključci: Ovaj prikaz slučaja još je jedan podsjetnik da su, iako iznimno rijetke, solitarne koštane metastaze karcinoma vagine moguće. Budući da simptomi metastaza u kostima imitiraju razna benigna stanja, u pacijenata s progresivnim bolovima u kostima koji ne popuštaju na terapiju analgeticima, važno je uzeti u obzir i metastaze kao moguću dijagnozu.
Aim: Primary vaginal cancer is rare, comprising about 3% of all gynaecological malignancies. Solitary bone metastases to appendicular skeleton are extremely rare and there are only few published reports. We report the case of isolated metastasis in the tibia as a feature of primary squamous vaginal carcinoma. We present this case because of its rarity and for documentation and discussion purposes. Case report: We present a case of a 44-year old woman diagnosed with squamos vaginal cancer in June 2015. Computed tomography of the thorax, abdomen and pelvis revealed no distant metastases. She was treated with interstitial intracavitary brachytherapy and concomitant chemoradiotherapy. In March 2016 she was admitted to our hospital because of the swelling and the pain in the lower right leg. There was no history of trauma and plain radiographs were normal. Two months later, after further progression of pain, plain radiographs showed intramedullary permeative bone lesion with cortical disruption of tibial dyaphisis and local soft tissue swelling. MRI and core needle biopsy confirmed vaginal cancer metastasis containing tumor cells identical to the primary tumor. The patient was treated with radiotherapy and chemotherapy. Despite the treatment there was further progression of the disease with multiple bone metastases and eventually lung and brain metastases. Conclusion: This case report is another reminder that although extremely rare, solitary metastatic bone lesions of vaginal cancer are possible. Since symptoms mimic various benign conditions, it is important to consider bone metastasis as possible diagnosis in patients with progressive bone pain not responding to analgesic treatment.
Databáze: OpenAIRE
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