Extramedullary Leukemia, Presenting at the Cervix of the Uterus

Extramedullary relapse of leukemia is encountered more often than in the past. The reason is that leukemia survival rates increase with improved treatment schemes. We present a rare case of involvement of the cervix of the uterus in an adult B Acute Lymphocytic Leukemia (B-ALL) survivor. Relapses af...

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Main Authors: Nikolaos Tsagkas, Androniki Troussa, George Vorgias, Olympia Tzaida, Nektaria Zagorianakou, Maria Gonidi
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2020/8492036
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author Nikolaos Tsagkas
Androniki Troussa
George Vorgias
Olympia Tzaida
Nektaria Zagorianakou
Maria Gonidi
author_facet Nikolaos Tsagkas
Androniki Troussa
George Vorgias
Olympia Tzaida
Nektaria Zagorianakou
Maria Gonidi
author_sort Nikolaos Tsagkas
collection DOAJ
description Extramedullary relapse of leukemia is encountered more often than in the past. The reason is that leukemia survival rates increase with improved treatment schemes. We present a rare case of involvement of the cervix of the uterus in an adult B Acute Lymphocytic Leukemia (B-ALL) survivor. Relapses affect various organs but rarely the female genital tract. Nevertheless, in this case, a woman with a history of induced amenorrhea due to treatment for leukemia presented to the gynecologist because of vaginal spotting. Colposcopy evaluation of the vagina/cervix, sonography and cytological and histological sampling established the diagnosis of leukemia relapse in the cervix of the uterus. Under these circumstances, our study highlights the rare extramedullary presentation of leukemia in the cervix of the uterus of a young lady considered to be disease-free and listed for bone marrow transplantation. In this rare case of relapse in the cervix of the uterus, Pap smears alarmed physicians, and radiology examinations assisted the diagnostic workup. Still, only biopsy, microscopic evaluation, and immunohistochemistry studies established the exact diagnosis. Prognosis in the situation of extramedullary disease relapse in the female genital tract was poor, but gynecologists’ high suspicion led to a prompt diagnosis. Survival is in general limited, but together with high suspicion, multidisciplinary team involvement is imperative to improve the reduced chances of survival.
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spelling doaj-art-6d345f2c7f5e48a7abc2fe35dba75cf02025-08-20T02:06:44ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922020-01-01202010.1155/2020/84920368492036Extramedullary Leukemia, Presenting at the Cervix of the UterusNikolaos Tsagkas0Androniki Troussa1George Vorgias2Olympia Tzaida3Nektaria Zagorianakou4Maria Gonidi5Obstetrics and Gynecology, General Hospital of Lefkas, Aristoteli Valaoriti 29, 31100 Lefkas, GreecePrivate Practice, Obstetrics and Gynecology, Corfu, GreeceGynecology Clinic of Metaxa Cancer Hospital of Piraeus, Botasi 51, 18537 Athens, GreecePathology Department of Metaxa Cancer Hospital of Piraeus, Botasi 51, 18537 Athens, GreecePrivate Practice, Cytopathology Laboratory, Ioannina, GreecePrivate Practice, Cytopathology Laboratory, Corfu, GreeceExtramedullary relapse of leukemia is encountered more often than in the past. The reason is that leukemia survival rates increase with improved treatment schemes. We present a rare case of involvement of the cervix of the uterus in an adult B Acute Lymphocytic Leukemia (B-ALL) survivor. Relapses affect various organs but rarely the female genital tract. Nevertheless, in this case, a woman with a history of induced amenorrhea due to treatment for leukemia presented to the gynecologist because of vaginal spotting. Colposcopy evaluation of the vagina/cervix, sonography and cytological and histological sampling established the diagnosis of leukemia relapse in the cervix of the uterus. Under these circumstances, our study highlights the rare extramedullary presentation of leukemia in the cervix of the uterus of a young lady considered to be disease-free and listed for bone marrow transplantation. In this rare case of relapse in the cervix of the uterus, Pap smears alarmed physicians, and radiology examinations assisted the diagnostic workup. Still, only biopsy, microscopic evaluation, and immunohistochemistry studies established the exact diagnosis. Prognosis in the situation of extramedullary disease relapse in the female genital tract was poor, but gynecologists’ high suspicion led to a prompt diagnosis. Survival is in general limited, but together with high suspicion, multidisciplinary team involvement is imperative to improve the reduced chances of survival.http://dx.doi.org/10.1155/2020/8492036
spellingShingle Nikolaos Tsagkas
Androniki Troussa
George Vorgias
Olympia Tzaida
Nektaria Zagorianakou
Maria Gonidi
Extramedullary Leukemia, Presenting at the Cervix of the Uterus
Case Reports in Obstetrics and Gynecology
title Extramedullary Leukemia, Presenting at the Cervix of the Uterus
title_full Extramedullary Leukemia, Presenting at the Cervix of the Uterus
title_fullStr Extramedullary Leukemia, Presenting at the Cervix of the Uterus
title_full_unstemmed Extramedullary Leukemia, Presenting at the Cervix of the Uterus
title_short Extramedullary Leukemia, Presenting at the Cervix of the Uterus
title_sort extramedullary leukemia presenting at the cervix of the uterus
url http://dx.doi.org/10.1155/2020/8492036
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AT olympiatzaida extramedullaryleukemiapresentingatthecervixoftheuterus
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