# Metastatic carcinoma of the cervix with unexpected ovarian involvement: A rare case report and review of the literature

## TL;DR

This paper reports a rare case of cervical cancer that unexpectedly spread to the ovary and caused ureter compression, responding well to treatment.

## Contribution

The paper presents a unique case of cervical cancer with ovarian metastasis and ureter obstruction at the pelvic brim, not previously reported.

## Key findings

- The patient had a large ovarian metastatic mass from cervical cancer causing ureter compression at the pelvic brim.
- Chemoradiotherapy effectively treated the cancer with no residual cervical mass observed.
- The case highlights the need for improved screening and imaging for late-stage cervical adenocarcinoma.

## Abstract

Ovarian metastasis from cervical carcinoma (CC) is rare. As adenocarcinomas tend to develop within the endocervix, they may be hidden in Pap tests and have a normal Colposcopic appearance. Only a limited number of Ovarian metastases from CC are reported in the literature, and various aspects of this involvement still need to be clarified.

In this study, we reported a case of unexpected ovarian metastatic cervical cancer in a 57-year-old female. The uniqueness of the present case was the large size of the metastatic ovarian mass, which led to ureter compression from the AC and the good response to chemoradiotherapy. Unlike the previously reported cases in which the ureter was obstructed at the ureter-bladder junction(trigone), in our case, ureter obstruction occurred at the level of the pelvic brim.

Even though ovarian metastasis of cervical cancer is rare, chemoradiotherapy (CRT) manifests a good response with no remnant cervical mass observed in the surgery, which is compatible with the result of a normal Positron emission tomography scan (PET).

Cervical adenocarcinoma can often be diagnosed at very late stages, presenting with large ovarian masses and symptoms of ureter compression. This highlights a lack of awareness regarding appropriate cervical cancer screening tests. Moreover, there is a need for appropriate following imaging methods to differentiate pelvic masses and lymph nodes.

•A metastatic carcinoma of the cervix was observed with unexpected ovarian involvement.•Unlike the reported cases where the obstruction occurred in the trigone, the obstruction occurred in the ovary.•The patient had a good response to chemotherapy (CRT).

A metastatic carcinoma of the cervix was observed with unexpected ovarian involvement.

Unlike the reported cases where the obstruction occurred in the trigone, the obstruction occurred in the ovary.

The patient had a good response to chemotherapy (CRT).