A case of primary malignant lymphoma of the uterine cervix.
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Primary malignant lymphoma of the uterine cervix is rare among gynecologic malignancies, and is usually very difficult to diagnose. Treatment of this tumor is based on the Ann Arbor Staging for extranodal malignant lymphomas rather than FIGO Staging for cervical malignancies. We report the successful treatment of an advanced case of this rare tumor. A 62-year-old woman who had experienced general malaise, nausea, and vomiting for a few weeks visited Nagahama City Hospital in April, 1992. Gynecological examination revealed a huge mass occupying the whole pelvic cavity, and partially bulging into the vagina. Ultrasonography and x-ray CT suggested a malignant tumor arising from the uterus, but Pap smear test was negative and distant metastasis was not detected. Laparotomy revealed that the uterine corpus was atrophic and the tumor originated from the uterine cervical region, extended to the pelvic wall through bilateral cardinal ligaments. Widespread metastases were also detected in the pelvic lymph nodes. Peritoneal cytology was positive. These findings corresponded to Ann Arbor stage IV and FIGO stage IIIB. Therefore, partial resection of the tumor and left uretero-cutaneostomy were performed. Pathological diagnosis was non-Hodgkin lymphoma of diffuse, small cell, and non cleaved type. Postoperative chemo-therapy with VEPA (vincristine, cyclophosphamide, prednisolone, and farmorubicin) was very effective and the size of the tumor markedly reduced. During subsequent surgery in October, 1992, hysterectomy with pelvic lymph node biopsies was performed. The tumor was completely replaced by xanthoma and no malignant cells were identified in any lymph node specimen. [Adv Obstet Gynecol 46 (4); 379-385, 1994 (H6. 7)]
- 近畿産科婦人科学会の論文
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