Primary peritoneal carcinoma is rare, presents with non-specific abdominal symptoms, is usually diagnosed late and is associated with a poor prognosis. A 51-year-old female with Primary Peritoneal Carcinoma Stage III-C, was initially treated with cytoreductive surgery and intravenous paclitaxel and carboplatin. After 28 months in remission, she developed tumor recurrence. She underwent tumor excision followed by combined intravenous paclitaxel and intraperitoneal carboplatin. The patient is alive and disease-free 5 years after the initial operation. This case was reported to inform our clinicians that the peritoneum can be the primary site of a rare malignancy. Prognosis may be poor but long-term survival can be achieved in younger patients with good performance status. Having a tumor that is sensitive to platinum-based chemotherapy can contribute to a longer survival even if the tumor was sub-optimally reduced.
Drug Therapy ; Cytoreduction Surgical Procedures

A 54-year old, single, nulligravid, without history of sexual contact, was admitted due to postmenopausal bleeding. Transrectal ultrasound revealed myoma uteri and thickened endometrium. She was thus scheduled to undergo endometrial curettage. However, prior to the performance of the endometrial sampling procedure, there was profuse vaginal bleeding with note of a possible prolapsed submucous myoma. She thus underwent emergency exploratory laparotomy with total hysterectomy and bilateral salpingooophorectomy.

Intraoperatively, necrotic masses were noted within the endocervical canal. Frozen section of the uterus and these masses revealed malignancy. Intraoperative referral to a gynecologic oncologist was done and bilateral pelvic lymphadenectomy and surgical staging were performed. Final histopathologic report revealed Cervical Adenosquamous Carcinoma. She subsequently underwent external beam radiotherapy and vaginal brachytherapy.

With the knowledge that almost all cases of cervical cancer is due to the Human Papilloma Virus (HPV), that this virus is almost exclusively transmitted by sexual contact, and the fact that she never engaged in sexual practices, there was doubt as to the source of the cancer. To help resolve this issue, an HPV DNA Polymerase Chain Reaction assay was performed on paraffin block samples and these all turned out negative for HPV. She may possess one of the rarest forms of cervical cancer - one that is not associated with the Human Papilloma Virus.

Human ; Female ; Middle Aged ; Uterine Cervical Neoplasms ; Papillomaviridae ; Brachytherapy ; Carcinoma, Adenosquamous ; Laparotomy ; Myoma ; Leiomyoma ; Endometrium ; Uterine Hemorrhage ; Hysterectomy