Rare Sites of Metastases to the Breast and Integumentary System in Advanced Cervical Cancer at Initial Presentation in Eastern Uganda: A Case Report.
4 affiliations
- 1Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
- 2Department of Obstetrics and Gynaecology, Mbale Regional Referral Hospital, Mbale, Uganda.
- 3Department of Pathology, Mbale Surgical Centre, Mbale, Uganda.
- 4Department of Pathology, Uganda Cancer Institute, Kampala, Uganda.
Abstract
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. 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. 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.
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BibTeX
@article{nteziyaremye2026rare,
title = {{Rare Sites of Metastases to the Breast and Integumentary System in Advanced Cervical Cancer at Initial Presentation in Eastern Uganda: A Case Report.}},
author = {Julius Goodwill Nteziyaremye and Derrick Akandwanaho and Linda Lutada Adong},
journal = {International medical case reports journal},
year = {2026},
month = nov,
doi = {10.2147/imcrj.s650965},
url = {https://europepmc.org/article/MED/42999667},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Rare Sites of Metastases to the Breast and Integumentary System in Advanced Cervical Cancer at Initial Presentation in Eastern Uganda: A Case Report.
AU - Julius Goodwill Nteziyaremye
AU - Derrick Akandwanaho
AU - Linda Lutada Adong
PY - 2026
DA - 2026/11/03
JO - International medical case reports journal
DO - 10.2147/imcrj.s650965
UR - https://europepmc.org/article/MED/42999667
AB - 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. 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. 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.
SN - 1179-142X
ER -