A rare clinical case of uterine cancer with a congenital malformation of the genital organs

Abstract

Endometrial cancer is one of the most common options malignant neoplasms of the female reproductive system. At the same time, in the general structure of female oncopathology, cases of this disease in patients with developmental anomalies of the genital organs are extremely rare. When studying scientific publications, only 26 described clinical cases of uterine cancer in patients with genital malformations were found. The article presents a clinical case of endometrioid carcinoma in a 75-year-old woman with a duplication of uterus. Based on clinical performance, ultrasound investigation results, magnetic-resonance imaging and histological studies of endometrial scrapings was diagnosed duplication of uterus with endometrial cancer IB (cT1вNхМ0), G2 (morphological type — endometrioid carcinoma). With this pathology, surgical treatment is considered as the most effective way to fight uterine cancer, in some cases combined with other methods. Both laparotomic and laparoscopic interventions are recommended, provided that pelvic and lumbar lymph node dissection can be performed according to indications. The operation was carried out in the amount of laparotomy, B2 — type modified radical hysterectomy, with C3 pelvic lymph node dissection, omentectomy. The result of the postoperative histological examination confirmed the preoperative diagnosis. The postoperative period was without specific findings. The presented rare clinical case demonstrates necessity to give careful attention to patients with a congenital malformation of the genital organs. Timely diagnosis and diagnosis verification will allow for adequate treatment, which will affect the prognosis of survival. At the same time, the prognosis is largely determined by the stage of the process, the depth of the invasive lesion, and the histological type of the tumor.

Keywords

duplication of uterus / endometrial cancer / endometrioid carcinoma / malformations of the uterus / postmenopause / uterine cancer / rare case

References

[1] Saravelos SH, Cocksedge KA, Li TC. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update. 2008;14(5):415–429. DOI: 10.1093/humupd/dmn018

[2] Saravelos S.H., Cocksedge K.A., Li T.C. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal // Human reproduction update. 2008. Vol. 14, No. 5. P. 415–429. DOI: 10.1093/humupd/dmn018

[3] Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7(2):161–174. DOI: 10.1093/humupd/7.2.161

[4] Grimbizis G.F., Camus M., Tarlatzis B.C., Bontis J.N., Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results // Hum. Reprod. Update. 2001. Vol. 7, No. 2. P. 161–174. DOI: 10.1093/humupd/7.2.161

[5] Chan YY, Jayaprakasan K, Zamora J, et al. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update. 2011;17(6):761–771. DOI: 10.1093/humupd/dmr028

[6] Chan Y.Y., Jayaprakasan K., Zamora J., et al. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review // Hum. Reprod. Update. 2011. Vol. 17, No. 6. P. 761–771. DOI: 10.1093/humupd/dmr028

[7] Adamyan LV, Kulakov VI, Chaschukoeva AZ. Malformations of the uterus and vagina. Moscow: Meditsina Publ.; 1998. 328 p. (In Russ.)

[8] Адамян Л.В., Кулаков В.И., Хашукоева А.З. Пороки развития матки и влагалища. М.: Медицина, 1998. 328 с.

[9] Bobkova MV, Puchko TK, Adamyan LV. Reproduction in women with congenital uterus and vagina anomalies. Russian Journal of Human Reproduction. 2018;24(2):42–53. (In Russ.) DOI: 10.17116/repro201824242-53

[10] Бобкова М.В., Пучко Т.К., Адамян Л.В. Репродуктивная функция у женщин с пороками развития матки и влагалища // Проблемы репродукции. 2018. Т. 24, № 2. С. 42–53. DOI: 10.17116/repro201824242-53

[11] Shibelgut NM, Batina NA, Еlgina SI, et al. The course of pregnancy and childbirth with abnormal development of the genitals (two-horned uterus). Mother and Baby in Kuzbass. 2022;89(2):56–61. (In Russ.) DOI: 10.24412/2686-7338-2022-2-56-61

[12] Шибельгут Н.М., Батина Н.А., Елгина С.И., и др. Течение беременности и родов при аномалии развития половых органов (двурогой матке) // Мать и дитя в Кузбассе. 2022. Т. 89, № 2. С. 56–61. DOI: 10.24412/2686-7338-2022-2-56-61

[13] Chan YY, Jayaprakasan K, Tan A. Reproductive outcomes in women with congenital uterine anomalies: A systematic review. Ultrasound Obstet Gynecol. 2011;38(4):371–382. DOI: 10.1002/uog.10056

[14] Chan Y.Y., Jayaprakasan K., Tan A. Reproductive outcomes in women with congenital uterine anomalies: A systematic review. Ultrasound // Obstet. Gynecol. 2011. Vol. 38, No. 4. P. 371–382. DOI: 10.1002/uog.10056

[15] Yoo RE, Cho JY, Kim SY, Kim SH. Magnetic resonance evaluation of Müllerian remnants in Mayer-Rokitansky-Küster-Hauser syndrome. Korean J Radiol. 2013;14(2):233–239. DOI: 10.3348/kjr.2013.14.2.233

[16] Yoo R.E., Cho J.Y., Kim S.Y., Kim S.H. Magnetic resonance evaluation of Müllerian remnants in Mayer-Rokitansky-Küster-Hauser syndrome // Korean J. Radiol. 2013. Vol. 14, No. 2. P. 233–239. DOI: 10.3348/kjr.2013.14.2.233

[17] Arakelyan AS, Bychenko VG, Adamyan LV, Luzhina IA, Stepanian AA. Clinical and diagnostic aspects of the management of patients with malformations of the uterus and vagina: the place and role of magnetic resonance imaging in combination with laparoscopy. Russian Journal of Human Reproduction. 2021;27(4):69–83. (In Russ.) DOI: 10.17116/repro20212704169

[18] Аракелян А.С., Быченко В.Г., Адамян Л.В., Лужина И.А., Степанян А.А. Клинико-диагностические аспекты ведения больных с пороками развития матки и влагалища: место и роль магнитно-резонансной томографии в сочетании с лапароскопией // Проблемы репродукции. 2021. Т. 27, № 4. С. 69–83. DOI: 10.17116/repro20212704169

[19] Solovev IA, Surov DA, Vasilchenko MV, et al. Immediate results of extended and combined operations in patients with locally advanced pelvic cancer. Military Medical Journal. 2021;342(3):37–45. (In Russ.)

[20] Соловьев И.А., Суров Д.А., Васильченко М.В., и др. Непосредственные результаты расширенных и комбинированных операций у больных с местно-распространенным раком органов малого таза // Военно-медицинский журнал. 2021. Т. 342, № 3. С. 37–45.

[21] Ul’rikh EA, Urmancheeva AF. Rare malignant gynecological tumors. Saint Petersburg: Eco-Vector Publ.; 2022. 247 p. (In Russ.)

[22] Ульрих Е.А., Урманчеева А.Ф. Редкие злокачественные гинекологические опухоли. СПб.: Эко-Вектор, 2022. 247 с.

[23] Gao J, Zhang J, Tian W, et al. Endometrial cancer with congenital uterine anomalies: 3 case reports and a literature review. Cancer Biol Ther. 2017;18(3):123–131. DOI: 10.1080/15384047.2017.1281495

[24] Gao J., Zhang J., Tian W., et al. Endometrial cancer with congenital uterine anomalies: 3 case reports and a literature review // Cancer Biol. Ther. 2017. Vol. 18, No. 3. P. 123–131. DOI: 10.1080/15384047.2017.1281495

[25] Chernyshova AL, Коlomiets LA, Truschuk YuM. Clinical case of endometrial cancer in a patient with complete doubling of the uterus and cervix. Tumors of female reproductive system. 2021;17(2): 100–103. (In Russ.) DOI: 10.17650/1994-4098-2021-17-2-100-103

[26] Чернышова А.Л., Коломиец Л.А., Трущук Ю.М. Клинический случай рака эндометрия у пациентки с полным удвоением матки и шейки матки // Опухоли женской репродуктивной системы. 2021. Т. 17, № 2. С. 100–103. DOI: 10.17650/1994-4098-2021-17-2-100-103

[27] Colombo N, Preti E, Landoni F, et al. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(6):i33–i38.

[28] Colombo N., Preti E., Landoni F., et al. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up // Ann. Oncol. 2013. Vol. 24, No. 6. P. i33–i38.

[29] Amanta F, Mirzab M, Creutzbergc C. FIGO cancer report 2012. Cancer of the corpus uteri. Int J Gynecol Obstet. 2012;119(2):110–117.

[30] Amanta F., Mirzab M., Creutzbergc C. FIGO cancer report 2012. Cancer of the corpus uteri // Int. J. Gynecol. Obstet. 2012. Vol. 119, No. 2. P. 110–117.

[31] Cade TJ, Quinn MA, McNally OM. Predictive value of magnetic resonance imaging in assessing myometrial invasion in endometrial cancer: is radiological staging sufficient for planning conservative treatment? Int J Gynecol Cancer. 2010;20(7):1166–1169.

[32] Cade T.J., Quinn M.A., McNally O.M. Predictive value of magnetic resonance imaging in assessing myometrial invasion in endometrial cancer: is radiological staging sufficient for planning conservative treatment? // Int. J. Gynecol. Cancer. 2010. Vol. 20, No. 7. P. 1166–1169.

[33] Ortashi O, Jain S, Emannuel O. Evaluation of the sensitivity, specificity, positive and negative predictive values of preoperative magnetic resonance imaging for staging endometrial cancer. A prospective study of 100 cases at the Dorset Cancer Centre. Eur J Obstet Gynecol Reprod Biol. 2008;137(2): 232–235.

[34] Ortashi O., Jain S., Emannuel O. Evaluation of the sensitivity, specificity, positive and negative predictive values of preoperative magnetic resonance imaging for staging endometrial cancer. A prospective study of 100 cases at the Dorset Cancer Centre // Eur. J. Obstet. Gynecol. Reprod. Biol. 2008. Vol. 137, No. 2. P. 232–235.

[35] Gavrish YuE, Artemieva AS, Trifanov YuN, et al. Endometrial cancer in patients older than 70 years: clinical and morphological characteristics and long-term results. Voprosy onkologii. 2019;65(3): 414–421. (In Russ.) DOI: 10.37469/0507-3758-2019-65-3

[36] Гавриш Ю.Е., Артемьева А.С., Трифанов Ю.Н., и др. Рак эндометрия у пациенток старше 70 лет: клинико-морфологическая характеристика и отдаленные результаты // Вопросы онкологии. 2019. Т. 65, № 3. С. 414–421. DOI:10.37469/0507-3758-2019-65-3

[37] Wang HL, Ren YF, Yang J. Total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer: a meta-analysis. Asian Pac J Cancer Prev. 2013;14(4):2515–2519.

[38] Wang H.L., Ren Y.F., Yang J. Total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer: a meta-analysis // Asian Pac. J. Cancer Prev. 2013. Vol. 14, No. 4. P. 2515–2519.

[39] Colombo N, Creutzberg C, Amant F. ESMO-ESGO-ESTRO Consensus conference on endometrial cancer. Diagnosis, treatment and follow-up. Int J Gynecol Cancer. 2016;26(1):2–30.

[40] Colombo N., Creutzberg C., Amant F. ESMO-ESGO-ESTRO Consensus conference on endometrial cancer. Diagnosis, treatment and follow-up // Int. J. Gynecol. Cancer. 2016. Vol. 26, No. 1. P. 2–30.

RIGHTS & PERMISSIONS

Eco-Vector