Abstract
Background : We report a case of advanced cervical cancer with a large retroperitoneal lymph node metastasis, which was preoperatively misdiagnosed as a uterine leiomyoma.
Case : A 43-year-old woman was referred to our department for pelvic pain. Gynecological examination revealed unremarkable findings. Transvaginal ultrasound and magnetic resonance imaging showed a solid mass measuring around 6 cm in diameter in the upper pelvis. Based on the findings, this solid mass was diagnosed as a subserosal uterine leiomyoma. Cervical and endometrial smears showed no malignant findings. The patient was taken up for surgery, when it became apparent that the mass was retroperitoneal, probably a lymph node swelling. Biopsy of the mass revealed the presence of metastatic highly differentiated squamous cell carcinoma.
Conclusion : Systemic examination for the primary site resulted in vain. No primary cancer could be detected. Then, cervical cytology and endocervical curettage were performed again, which led to the diagnosis of cervical cancer. Finally, the uterine cervix was determined to be the primary origin of the retroperitoneal lymph node metastasis.
