Squamous cell carcinoma of the sigmoid colon following hysterectomy in patient with cervical cancer

초록

Cervical cancer is the fourth most common cancer in women worldwide. Up to 30% of patients treated for this disease will have tumor recurrence, most commonly in the first 2 years after treatment. The recurrences after radical hysterectomy usually occur locally as central pelvic recurrences because cervical cancer can spread to contiguous organs including the vagina, peritoneum, urinary bladder, ureter, rectum, and paracervical tissue. Therefore, the cervical cancer metastasis to the sigmoid colon is relatively rare, which can easily be a misdiagnosis. We herein present a case of isolated squamous cell carcinoma of the sigmoid colon following laparoscopic radical hysterectomy in patient with cervical cancer. A 40-year-old woman with a history of appropriately operated and managed stage IIA cervical cancer two and a half years previously was newly found to have a sigmoid colon mass by colonoscopy and computed tomography of the abdomen and pelvis. The patient subsequently underwent a laparoscopic anterior resection under a diagnosis of metachronous metastasis of the sigmoid colon from cervical cancer, which was finally confirmed by pathological examination to be squamous cell carcinoma of the sigmoid colon. The surgical pathology from the resected colon was reported that the tumor invaded through the muscularis propria into the pericolic adipose tissues and 2 out of 19 regional lymph nodes were positive for tumors. Immunohistochemical analysis demonstrated high Ki-67 indexes (90-95%) and positivity for P16, and PD-L1, indicating metastatic squamous cell carcinoma, clinically from cervical cancer. The patient was discharged on postoperative day 7 without complications and referred to the oncologic department for palliative chemotherapy. We want to emphasize this unusual progression of cervical cancer and bowel habit change secondary to sigmoid colon metastasis from this disease. We should keep in mind that such progression may occur with the advent of more