Rare Sites of Metastases to the Breast and Integumentary System in Advanced Cervical Cancer at Initial Presentation in Eastern Uganda: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Background: Cervical cancer (CC) is the leading Gynaecological cancer in Uganda with an estimated 6959 women diagnosed, and 4607 annual deaths. About 60-80% of CC patients present with advanced stage disease with either local spread or with distant metastases. For those with distant metastases, the most common sites of spread are the lungs and supraclavicular lymph nodes. Breast and integumentary system metastases are very rare. We present a case with such metastases managed in eastern Uganda. Case Presentation: A 72 years old, Ugandan black African female, came in with a 13 months history of intermittent postmenopausal bleeding and associated abnormal vaginal discharge. She had repeatedly been managed from the nearest health facility for recurrent urinary tract infection and sexually transmitted diseases with no improvement. On examination at Mbale Regional Referral Hospital, she had poor performance status, cachexic, with bilateral pitting, tender poedal oedema, left breast masses and cutaneous nodules on the anterior aspect of the left thigh. Abdominal exam revealed a bulky uterus. On vagina examination, a large easily bleeding cervical tumour measuring about 8 cm × 7 cm and involving the upper 1/3 of the vagina was found. Bimanual pelvic exam revealed bilateral parametria involvement and bilateral pelvic side wall extension. Biopsies of the cervical, breast and the cutaneous masses were positive for high grade adenocarcinoma. Immunohistochemistry (IHC) for breast and cutaneous biopsies was positive for 16-kilodalton protein (P16), and negative for Oestrogen receptors (ER) and Progesterone receptors (PR). A diagnosis of cervical adenocarcinoma stage IVB (with breast and integument system metastases), with obstructive uropathy and probable deep venous thrombosis was made. She was offered total palliation and unfortunately succumbed on day 3 of admission. Conclusion: Cervical adenocarcinoma stage IVB with breast and integumentary metastases portends poor prognosis. Gynaecologic Oncologists and other service providers need to do thorough exam and investigations to rule out metastases to rare sites. This will aid appropriate counselling during care.
Institutions: Mbale Hospital, Busitema University, Uganda Cancer Institute
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,320
OpenAlex ID: W7225177277