Pancreatic Metastases from Cervical Squamous Cell Carcinoma: Systematic Review of the Literature and Case Report

TL;DR

This paper reviews rare cases of cervical cancer spreading to the pancreas and presents a new case, highlighting the challenges in diagnosis and treatment.

Contribution

The study provides a systematic review and reports a new case of pancreatic metastases from cervical squamous cell carcinoma.

Findings

Pancreatic metastases from cervical cancer are rare and typically occur in advanced stages with poor outcomes.

Surgical resection may benefit selected patients with isolated lesions, but systemic therapy is more commonly used.

Immunotherapies show early promise but require further research for this rare condition.

Abstract

Background: Pancreatic metastases from cervical cancer are exceptionally rare, with limited cases described in the literature. Their diagnosis and management remain challenging due to the absence of standardized protocols and the often poor prognosis. Case Presentation: We report the case of a 39-year-old woman with a history of treated stage IIIB cervical squamous cell carcinoma who presented with a solitary mass in the pancreatic tail. Diagnosis was established through cross-sectional imaging, PET-CT, and EUS-guided needle biopsy. The patient underwent systemic chemotherapy and SBRT followed by surgical resection. Histopathological analysis confirmed metastatic squamous cell carcinoma associated with HPV. Despite an initially favorable recovery, peritoneal metastases developed three months later. The patient died seven months after surgery under palliative care after disease progression on immunotherapy. Methods: A systematic review following PRISMA guidelines was conducted across PubMed, Cochrane, and Embase (2000–2025) to identify case reports and series describing pancreatic metastases from cervical cancer. A total of 14 published cases, together with the present case, were analyzed for demographic, clinical, diagnostic, therapeutic, and outcome data. Results: The mean age at diagnosis was 52.5 years (range 36–70). Squamous cell carcinoma was the predominant histology (73%). The pancreatic head was the most common metastatic site (53%). Diagnosis typically relied on abdominal CT, PET-CT, and EUS-guided biopsy. Surgical resection was performed in 28.6% of cases, while systemic therapy—most commonly cisplatin, paclitaxel, and bevacizumab—remained the mainstay for inoperable patients. Conclusions: Pancreatic metastases from cervical cancer usually occur in advanced disease stages and are associated with poor outcomes. Accurate diagnosis requires integration of imaging and histopathology, with PET-CT useful for detecting additional metastases. Surgery may be beneficial in selected patients with isolated lesions, but systemic therapy remains the primary treatment for most. Emerging immunotherapies show promise but are still in early development. Multidisciplinary management and further research are needed to optimize outcomes in this rare presentation.

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