Successful management of cutaneous lymphangitis carcinomatosa arising from cervical cancer with paclitaxel-cisplatin and bevacizumab combination therapy: a case report and review of the literature

J Med Case Rep. 2019 Nov 7;13(1):328. doi: 10.1186/s13256-019-2262-x.

Abstract

Background: Globally, cervical cancer is the fourth most common cancer in women. Here, we report a case of cutaneous lymphangitis carcinomatosa arising from cervical cancer, an extremely rare and treatment-resistant condition.

Case presentation: A 64-year-old Japanese woman presented with genital bleeding. She was diagnosed as having stage IB1 squamous cell cervical cancer and subsequently treated with radiotherapy. Approximately 2 years after the curative radiotherapy, she developed itching, skin rash, and small nodules on her left femoral and pubic area. Slight 18F-fluorodeoxyglucose uptake was detected at her left femoral skin on positron emission tomography with computed tomography. A histopathological examination was performed on a biopsy sample from an erythematous macule on her left femoral skin and vulva. Consequently, she was diagnosed as having cutaneous lymphangitis carcinomatosa arising from cervical cancer. Paclitaxel (135 mg/m2), cisplatin (50 mg/m2), and bevacizumab (15 mg/kg) combination therapy was administered every 21 days. Both itching and rash improved after three treatment cycles. After the completion of six cycles, skin erythema in the femoral and vulval area disappeared completely. Our patient experienced a 25-month symptom-free interval after the last chemotherapy session.

Conclusion: Our findings suggest that combination chemotherapy plus bevacizumab is an effective therapeutic option in patients with cutaneous lymphangitis carcinomatosa arising from cervical cancer.

Keywords: Bevacizumab; Cervical cancer; Cutaneous lymphangitis carcinomatosa; Skin metastasis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab / therapeutic use*
  • Carcinoma, Squamous Cell / radiotherapy*
  • Cisplatin / therapeutic use
  • Female
  • Humans
  • Lymphangitis / drug therapy
  • Lymphangitis / pathology*
  • Middle Aged
  • Paclitaxel / therapeutic use
  • Treatment Outcome
  • Uterine Cervical Neoplasms / radiotherapy*

Substances

  • Bevacizumab
  • Paclitaxel
  • Cisplatin

Supplementary concepts

  • TP protocol