%0 Journal Article
%T An Unusual Cervical Tumor as Presentation of a Non-Hodgkin Lymphoma
%A Tom De Greve
%A Lieve Vanwalleghem
%A Achiel Van Hoof
%A Kenneth Coenegrachts
%A Philippe Van Trappen
%J Case Reports in Obstetrics and Gynecology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/549619
%X Rare cervical cancers are responsible for a minority of cases encountered by a clinician. However, behavioral patterns, management, and prognosis of certain rare cervical cancers differ from either squamous carcinomas or adenocarcinomas. Here we present a case of a locally advanced cervical tumor as a presentation of an extranodal cervical non-Hodgkin lymphoma (NHL), with a review of the current literature. 1. Introduction Cervical cancers, as well as their precursors, originate from either squamous or glandular cell lineage. Most cases of cervical cancer are therefore either squamous cell carcinomas or adenocarcinomas. Rare cervical malignancies include tumors such as adenosquamous carcinoma (3.0%), clear-cell carcinoma (1.1%), neuroendocrine carcinoma (0.6%), lymphoma (0.3%), leiomyosarcoma (0.2%), and lymphoepithelioma-like carcinoma (0.1%) [1]. Behavioral patterns, management, and prognosis of certain rare cervical cancers are different from either squamous or adenocarcinomas. Here we present a rare cervical tumor, extranodal cervical NHL, with an unusual clinical and radiological presentation. 2. Case A 75-year-old woman presented herself in our clinic with complaints of postmenopausal vaginal blood loss for a period of two weeks, bladder pressure, and a slight pain located at the right groin. Her past medical history consists of B-cell follicular NHL 18 years ago with right groin and thoracic lymph node involvement (stage IIIa). Treatment consisted of chemo- and radiation therapy, with no relapse until present. An irregular tumor mass of the cervix was visualized during gynecological examination. The surface was smooth with no exophytic or erosive components. The cervix cytology smear was normal. The bulky locally advanced cervical tumor extended in the right paracervical and parametrial tissue, fixating to the right pelvic rim, invading the posterior bladder wall and proximal 2/3 of the vaginal submucosa. No enlarged inguinal or supra clavicular lymph nodes were observed. On ultrasound examination a 4-by-4.2-centimeter highly vascularized cervical tumor extending into the right parametrium and bladder without mucosal infiltration was visualized. The right ureter seemed to be encased by the tumor causing hydroureteronephrosis. A magnetic resonance imaging (MRI) was performed showing a locally invasive tumor, with heterogenous high intensity signaling on T2-weighted images, most likely originating from the cervix with transmural invasion of the uterus. Invasion into the anterior part of the vagina, bladder, right pelvis, lumbosacral plexus, sacrum,
%U http://www.hindawi.com/journals/criog/2014/549619/