ArticleGynecologic oncology reports2026
Isolated ovarian metastasis in otherwise cervix-confined adenocarcinoma of the cervix: A rare clinical conundrum.
Article in Gynecologic oncology reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Isolated ovarian metastasis in otherwise early-stage cervical cancer is an extremely rare clinical scenario. According to the 2018 International Federation of Gynecology and Obstetrics, ovarian involvement does not change staging of cervical cancer. However, ovarian metastasis is known to indicate a worse prognosis. Case presentation: This report describes the clinical courses of two patients diagnosed with clinically early-stage adenocarcinoma of the cervix. Both patients had simple-appearing unilateral ovarian cysts, not concerning for metastasis. Each underwent primary surgical treatment, which then discovered unilateral ovarian metastasis of primary cervical cancer. Both patients were treated with adjuvant chemoradiation with cisplatin and pembrolizumab followed by pembrolizumab maintenance, per KEYNOTE A-18 as for Stage IVA disease. One patient's tumor had PD-L1 combined positive score (CPS) < 1, while the other patient had CPS of 12 but stopped immunotherapy early due to toxicity. Patients were disease-free 15-21 months following surgery. Conclusion: Given the limited data with this unique clinical presentation, some oncologists may choose to treat these patients as locally advanced disease, whereas others may favor treating ovarian involvement as distant metastasis. Further investigation of the best management for these patients is needed.
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