Indexed on: 01 Aug '18Published on: 01 Aug '18Published in: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
We report an extremely rare case of abnormal vaginal bleeding in a 66-year postmenopausal woman. A sterile speculum examination revealed no obvious tumour mass in the cervix. Serum levels of cancer antigen 125 and carcinoembryonic antigen were elevated at 480.3 IU/L and 19.3 ng/ml, respectively. Ultrasound showed a 4 × 3 × 2 cm hypoechoic solid mass on the left uterine adnexa, a 4-5 cm mass in the right adnexa, a 4 cm mass in the vesicouterine excavation and a 4-5 cm mass in the omentum. Finally, debulking surgery with tumour resection was performed. The bilateral ovarian tumours showed an infiltrative pattern of stromal invasion. Lymphovascular tumour emboli were present in bilateral ovaries. A careful histological examination revealed an eosinophilic cytoplasm that focally formed pear-like structures in the local area of the left ovary. Immunochemical analysis aided in the diagnosis of cervical squamous cell carcinoma involving the ovaries, fallopian tubes, uterine serosa, vesicouterine excavation, mesoappendix, mesentery, omentum, and paracolic sulcus. She was treated with surgery followed by cisplatin-based combination chemotherapy.