Cervicovaginal cytology and diagnosis of ovarian or peritoneal cancer: case report and literature review

Arch Gynecol Obstet. 2008 Feb;277(2):171-4. doi: 10.1007/s00404-007-0428-z. Epub 2007 Jul 25.

Abstract

Background: The characteristics of women presenting with asymptomatic ovarian or peritoneal cancer diagnosed following evaluation for abnormal cervicovaginal cytology are currently undefined.

Case: We present a case of a 51-year-old woman with asymptomatic stage IIIC ovarian cancer whose diagnosis was triggered by evaluation for adenocarcinoma and atypical glandular cells of undetermined significance (AGUS) on cervical cytology. We also present a case of a 53-year-old woman with AGUS cervical cytology on two occasions, found to have stage III peritoneal cancer at exploratory laparotomy.

Conclusion: We conducted a systematic search for articles to enable a review of asymptomatic cases of ovarian and peritoneal cancer, which presented via abnormal cervicovaginal cytology. The mean age at presentation with peritoneal cancer was 47.8 years old, which is similar to that of ovarian cancer of 50.5 years. Staging was provided in 13 cases, 11 of which (85%) were at least stage IIIA or greater. In terms of age greater than 50 years old, cervicovaginal cytology interpreted as AGUS, having a negative initial work-up, and advanced disease stage at presentation, the two cases presented are consistent with the literature. Abnormal cervicovaginal cytology as a presenting diagnostic criterion of cancer of the ovary or peritoneum is often representative of advanced disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma, Papillary / diagnosis
  • Adenocarcinoma, Papillary / therapy
  • Carcinoma, Papillary / diagnosis
  • Cervix Uteri / pathology*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / diagnosis*
  • Peritoneal Neoplasms / diagnosis*
  • Precancerous Conditions / pathology
  • Vaginal Smears*