REVIEW

Lung metastasis of gynecologic cancers

Brahmana Askandar Tjokroprawiro

Brahmana Askandar Tjokroprawiro
Department of Obstetrics and Gynecology, Dr. Soetomo General Academic Hospital, Medical Faculty - Universitas Airlangga, Surabaya, Indonesia. Email: [email protected]
Online First: August 05, 2021 | Cite this Article
Tjokroprawiro, B. 2021. Lung metastasis of gynecologic cancers. Bali Medical Journal 10(2): 701-707. DOI:10.15562/bmj.v10i2.2441


The lung is a distant metastatic site of gynecologic cancers. These metastases have clinical characteristics which can be solitary, multiple, solid, or manifest by pleural effusion. Diagnosing and managing lung metastasis is challenging because each type of gynecological cancer has different clinical characteristics. Some gynecologic cancers have tumor markers that can help diagnose lung metastasis; however, others do not have them. The options for managing lung metastasis in gynecologic cancer include; chemotherapy, surgery, or combination therapy. The clinical aspects of lung metastasis from cervical, endometrial, ovarian, vaginal, and vulvar cancers and gestational trophoblastic neoplasia were discussed in this article.

References

Martínez-Jiménez S, Rosado-de-Christenson ML, Walker CM, Kunin JR, Betancourt SL, Shoup BL, et al. Imaging features of thoracic metastases from gynecologic neoplasms. Radiographics. 2014;34(6):1742-54.

Hacker NF, Rao A. Surgical management of lung, liver and brain metastases from gynecological cancers: a literature review. Gynecologic Oncology Research and Practice. 2016;3(1):7.

Mukai Y, Koike I, Matsunaga T, Yokota NR, Takano S, Sugiura M, et al. Radiation Therapy for Uterine Cervical Cancer With Lung Metastases Including Oligometastases. In Vivo. 2019;33(5):1677-84.

Li H, Wu X, Cheng X. Advances in diagnosis and treatment of metastatic cervical cancer. J Gynecol Oncol. 2016;27(4).

Zhao H, Yao Y, Yang H, Ma D, Chen A. Hormone therapy as a management strategy for lung metastasis after 5 years of endometrial cancer: A case report and literature review. Medicine (Baltimore). 2017;96(51):e9223-e.

Chen X, Chen L, Zhu H, Tao J. Risk factors and prognostic predictors for Cervical Cancer patients with lung metastasis. J Cancer. 2020;11(20):5880-9.

Bouros D, Papadakis K, Siafakas N, Fuller AF, Jr. Natural history of patients with pulmonary metastases from uterine cancer. Cancer. 1996;78(3):441-7.

Wang K, Chen Y. Management and prognostic analysis of patients with gestational trophoblastic neoplasia (GTN) in FIGO stage IV and its special type. Clinical & Experimental Metastasis. 2021;38(1):47-59.

Frijstein MM, Lok C, van Trommel NE, Ten Kate-Booij MJ, Massuger L, van Werkhoven E, et al. Lung metastases in low-risk gestational trophoblastic neoplasia: a retrospective cohort study. Bjog. 2020;127(3):389-95.

Staples JN, Podwika S, Duska L. The role of pulmonary resection in the management of metastatic gestational trophoblastic neoplasia: Two cases of durable remission following surgery for chemo-resistant disease. Gynecol Oncol Rep. 2019;30:100496-.

Anile M, Mantovani S, Pecoraro Y, Carillo C, Gherzi L, Pagini A, et al. Pulmonary metastasectomy in uterine malignancies: outcome and prognostic factors. J Thorac Dis. 2017;9(Suppl 12):S1273-S7.

Adachi M, Mizuno M, Mitsui H, Kajiyama H, Suzuki S, Sekiya R, et al. The prognostic impact of pulmonary metastasectomy in recurrent gynecologic cancers: a retrospective single-institution study. Nagoya J Med Sci. 2015;77(3):363-72.

Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. International Journal of Gynecology & Obstetrics. 2018;143(S2):22-36.

Zhou S, Peng F. Patterns of metastases in cervical cancer: a population-based study. Int J Clin Exp Pathol. 2020;13(7):1615-23.

de Juan A, Redondo A, Rubio MJ, García Y, Cueva J, Gaba L, et al. SEOM clinical guidelines for cervical cancer (2019). Clinical and Translational Oncology. 2020;22(2):270-8.

Valenti G, Vitale SG, Tropea A, Biondi A, Laganà AS. Tumor markers of uterine cervical cancer: a new scenario to guide surgical practice? Updates in Surgery. 2017;69(4):441-9.

Schueller G, Herold CJ. Lung metastases. Cancer Imaging. 2003;3(2):126-8.

Ki EY, Lee KH, Park JS, Hur SY. A Clinicopathological Review of Pulmonary Metastasis from Uterine Cervical Cancer. Cancer Res Treat. 2016;48(1):266-72.

Hoogendam JP, Zweemer RP, Verkooijen HM, de Jong PA, van den Bosch MAAJ, Verheijen RHM, et al. No Value for Routine Chest Radiography in the Work-Up of Early Stage Cervical Cancer Patients. PLOS ONE. 2015;10(7):e0131899.

Bradley SH, Abraham S, Callister MEJ, Grice A, Hamilton WT, Lopez RR, et al. Sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms: a systematic review. British Journal of General Practice. 2019;69(689):e827.

Yamamoto K, Yoshikawa H, Shiromizu K, Saito T, Kuzuya K, Tsunematsu R, et al. Pulmonary metastasectomy for uterine cervical cancer: a multivariate analysis. Ann Thorac Surg. 2004;77(4):1179-82.

Tewari KS, Sill MW, Long HJ, 3rd, Penson RT, Huang H, Ramondetta LM, et al. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med. 2014;370(8):734-43.

Yousefi M, Dehghani S, Nosrati R, Ghanei M, Salmaninejad A, Rajaie S, et al. Current insights into the metastasis of epithelial ovarian cancer - hopes and hurdles. Cellular Oncology. 2020;43(4):515-38.

Charkhchi P, Cybulski C, Gronwald J, Wong FO, Narod SA, Akbari MR. CA125 and Ovarian Cancer: A Comprehensive Review. Cancers. 2020;12(12).

Matulonis UA, Sood AK, Fallowfield L, Howitt BE, Sehouli J, Karlan BY. Ovarian cancer. Nature Reviews Disease Primers. 2016;2(1):16061.

Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. Ovarian cancer in the world: epidemiology and risk factors. Int J Womens Health. 2019;11:287-99.

Chien JC-W, Fang C-L, Chan WP. Peritoneal tuberculosis with elevated CA-125 mimicking ovarian cancer with carcinomatosis peritonei: Crucial CT findings. EXCLI J. 2016;15:711-5.

Shaaban AM, Rezvani M, Elsayes KM, Baskin H, Mourad A, Foster BR, et al. Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features. RadioGraphics. 2014;34(3):777-801.

Kerr VE, Cadman E. Pulmonary metastases in ovarian cancer. Analysis of 357 patients. Cancer. 1985;56(5):1209-13.

Porcel JM, Diaz JP, Chi DS. Clinical implications of pleural effusions in ovarian cancer. Respirology. 2012;17(7):1060-7.

Xu J, Hussain I, Wang L, Deng K, Zhao L, Zhou K, et al. Incidence of and risk factors associated with lung metastases in newly diagnosed epithelial ovarian cancer with a look on prognosis after diagnosis: a population-based cohort study of the SEER database. Arch Gynecol Obstet. 2021.

Huang M-D, Weng H-H, Hsu S-L, Hsu L-S, Lin W-M, Chen C-W, et al. Accuracy and complications of CT-guided pulmonary core biopsy in small nodules: a single-center experience. Cancer Imaging. 2019;19(1):51.

Deng K, Yang C, Tan Q, Song W, Lu M, Zhao W, et al. Sites of distant metastases and overall survival in ovarian cancer: A study of 1481 patients. Gynecologic Oncology. 2018;150(3):460-5.

Vergote I, Denys H, De Greve J, Gennigens C, Van De Vijver K, Kerger J, et al. Treatment algorithm in patients with ovarian cancer. Facts Views Vis Obgyn. 2020;12(3):227-39.

Creasman WT, Odicino F, Maisonneuve P, Quinn MA, Beller U, Benedet JL, et al. Carcinoma of the Corpus Uteri. Int J Gynaecol Obstet. 2006;95 Suppl 1:S105-s43.

Lu KH, Broaddus RR. Endometrial Cancer. New England Journal of Medicine. 2020;383(21):2053-64.

Kurra V, Krajewski KM, Jagannathan J, Giardino A, Berlin S, Ramaiya N. Typical and atypical metastatic sites of recurrent endometrial carcinoma. Cancer imaging : the official publication of the International Cancer Imaging Society. 2013;13(1):113-22.

Li J, Sun L, Zhang Y, Cai S. Patterns of distant metastases in patients with endometrial carcinoma: A SEER population-based analysis. Journal of Clinical Oncology. 2019;37(15_suppl):e17109-e.

Martínez-Jiménez S, Rosado-de-Christenson ML, Walker CM, Kunin JR, Betancourt SL, Shoup BL, et al. Imaging Features of Thoracic Metastases from Gynecologic Neoplasms. RadioGraphics. 2014;34(6):1742-54.

Bouros D, Papadakis K, Siafakas N, Fuller AF, Jr. Patterns of pulmonary metastasis from uterine cancer. Oncology. 1996;53(5):360-3.

Otsuka I, Ono I, Akamatsu H, Sunamori M, Aso T. Pulmonary metastasis from endometrial carcinoma. Int J Gynecol Cancer. 2002;12(2):208-13.

Miyazaki S, Ishida J, Nara K, Ikeda T. Pulmonary metastasis from endometrial carcinoma. BMJ Case Rep. 2018;2018:bcr2017223916.

Zhao H, Yao Y, Yang H, Ma D, Chen A. Hormone therapy as a management strategy for lung metastasis after 5 years of endometrial cancer: A case report and literature review. Medicine (Baltimore). 2017;96(51):e9223.

Thigpen JT, Brady MF, Alvarez RD, Adelson MD, Homesley HD, Manetta A, et al. Oral Medroxyprogesterone Acetate in the Treatment of Advanced or Recurrent Endometrial Carcinoma: A Dose-Response Study by the Gynecologic Oncology Group. Journal of Clinical Oncology. 1999;17(6):1736-.

Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, et al. ESMO–ESGO–ESTRO consensus conference on endometrial cancer: Diagnosis, treatment and follow-up. Radiotherapy and Oncology. 2015;117(3):559-81.

Tangen IL, Werner HMJ, Berg A, Halle MK, Kusonmano K, Trovik J, et al. Loss of progesterone receptor links to high proliferation and increases from primary to metastatic endometrial cancer lesions. European Journal of Cancer. 2014;50(17):3003-10.

Sharami SRY, Saffarieh E. A review on management of gestational trophoblastic neoplasia. J Family Med Prim Care. 2020;9(3):1287-95.

Ngan HY, Kohorn EI, Cole LA, Kurman RJ, Kim SJ, Lurain JR, et al. Trophoblastic disease. Int J Gynaecol Obstet. 2012;119 Suppl 2:S130-6.

Seckl MJ, Sebire NJ, Fisher RA, Golfier F, Massuger L, Sessa C. Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24 Suppl 6:vi39-50.

Jagtap SV, Aher V, Gadhiya S, Jagtap SS. Gestational Trophoblastic Disease - Clinicopathological Study at Tertiary Care Hospital. J Clin Diagn Res. 2017;11(8):EC27-EC30.

Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Update on the diagnosis and management of gestational trophoblastic disease. International Journal of Gynecology & Obstetrics. 2018;143(S2):79-85.

Li X, Xu Y, Liu Y, Cheng X, Wang X, Lu W, et al. The management of hydatidiform mole with lung nodule: a retrospective analysis in 53 patients. Journal of gynecologic oncology. 2019;30(2):e16-e.

Kumar J, Ilancheran A, Ratnam SS. Pulmonary metastases in gestational trophoblastic disease: a review of 97 cases. Br J Obstet Gynaecol. 1988;95(1):70-4.

Thomakos N, Rodolakis A, Belitsos P, Zagouri F, Chatzinikolaou I, Dimopoulos A-M, et al. Gestational trophoblastic neoplasia with retroperitoneal metastases: a fatal complication. World J Surg Oncol. 2010;8:114-.

Page NM, Kemp CF, Butlin DJ, Lowry PJ. Placental peptides as markers of gestational disease. Reproduction. 2002;123(4):487-95.

May T, Goldstein DP, Berkowitz RS. Current Chemotherapeutic Management of Patients with Gestational Trophoblastic Neoplasia. Chemotherapy Research and Practice. 2011;2011:806256.

Dhanda S, Ramani S, Thakur M. Gestational Trophoblastic Disease: A Multimodality Imaging Approach with Impact on Diagnosis and Management. Radiology Research and Practice. 2014;2014:842751.

Gamer EI, Garrett A, Goldstein DP, Berkowitz RS. Significance of chest computed tomography findings in the evaluation and treatment of persistent gestational trophoblastic neoplasia. J Reprod Med. 2004;49(6):411-4.

Khattri S, Vivekanandarajah A, Varma S, Kong F. Secretion of beta-human chorionic gonadotropin by non-small cell lung cancer: a case report. Journal of Medical Case Reports. 2011;5(1):19.

Frijstein MM, Lok CAR, van Trommel NE, ten Kate-Booij MJ, Massuger L, van Werkhoven E, et al. Lung metastases in low-risk gestational trophoblastic neoplasia: a retrospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2020;127(3):389-95.

Vree M, van Trommel N, Kenter G, Sweep F, Ten Kate-Booij M, Massuger L, et al. The influence of lung metastases on the clinical course of gestational trophoblastic neoplasia: a historical cohort study. Bjog. 2016;123(11):1839-45.

Yu H, Li J, Zhu T, Xue X, Lu X. Evaluation and influence of lung metastasis on patient outcome in gestational trophoblastic neoplasia: A 10-year study at a single institution. Eur J Obstet Gynecol Reprod Biol. 2020;251:162-6.

Lurain JR. Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia. Am J Obstet Gynecol. 2011;204(1):11-8.

Lurain JR. High-risk metastatic gestational trophoblastic tumors. Current management. J Reprod Med. 1994;39(3):217-22.

Alkatout I, Schubert M, Garbrecht N, Weigel MT, Jonat W, Mundhenke C, et al. Vulvar cancer: epidemiology, clinical presentation, and management options. Int J Womens Health. 2015;7:305-13.

Tan A, Bieber AK, Stein JA, Pomeranz MK. Diagnosis and management of vulvar cancer: A review. J Am Acad Dermatol. 2019;81(6):1387-96.

Prieske K, Haeringer N, Grimm D, Trillsch F, Eulenburg C, Burandt E, et al. Patterns of distant metastases in vulvar cancer. Gynecol Oncol. 2016;142(3):427-34.

Pleunis N, Pouwer AW, Ploegmakers MJ, de Hullu JA, Pijnenborg J. Low incidence of pulmonary metastases in vulvar cancer patients: limited value of routine chest imaging based on a cohort study. Bjog. 2020.

Jafri SIM, Ali N, Farhat S, Malik F, Shahin M. The tell-tale heart: A case of recurrent vulvar carcinoma with cardiac metastasis and review of literature. Gynecol Oncol Rep. 2017;21:20-3.

Adams TS, Cuello MA. Cancer of the vagina. International Journal of Gynecology & Obstetrics. 2018;143(S2):14-21.

Shrivastava SB, Agrawal G, Mittal M, Mishra P. Management of Vaginal Cancer. Rev Recent Clin Trials. 2015;10(4):289-97.

Jahnke A, Domke R, Makovitzky J, Nizze H, Briese V. Vaginal metastasis of lung cancer: a case report. Anticancer Res. 2005;25(3a):1645-8.

Kim J-Y, Lee K-A, Kim B-G, Bae D-S, Lee J-W. Vaginal cancer with multiple liver and pulmonary metastases that achieved long-term survival. Obstet Gynecol Sci. 2013;56(6):416-9.


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