Management of Primary Uterine Cervix B-Cell Lymphoma Stage IE and Fertility Sparing Outcome: A Systematic Review of the Literature

Author:

Stabile Guglielmo1ORCID,Ripepi Chiara2,Sancin Lara2,Restaino Stefano3ORCID,Mangino Francesco Paolo1,Nappi Luigi4,Ricci Giuseppe12ORCID

Affiliation:

1. Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy

2. UCO Clinica Ostetrica e Ginecologica, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34137 Trieste, Italy

3. Obstetrics and Gynecology Unit, Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Udine University Hospital, 33100 Udine, Italy

4. Departments of Obstetrics and Gynecology and Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy

Abstract

The female genital tract can be involved as a secondary manifestation of disseminated lymphomas or leukaemia but can rarely be the primary site of so-called extranodal lymphomas. Primary lymphomas of the female genital tract can affect the uterine corpus, uterine cervix, vulva, vagina, or adnexa. Only about 0.008% of all cervical tumours are primary malignant lymphomas. The most common clinical presentation of primary cervical lymphomas is a history of prolonged minor abnormal uterine bleeding, while unstoppable bleeding at presentation is rarely reported in the literature. “B” symptoms related to nodal lymphomas are usually absent. Since vaginal bleeding is a nonspecific symptom, the first diagnostic hypothesis is usually of one of the more common female genital conditions such as cervical or endometrial carcinoma or sarcoma, fibroids, adenomyosis, or endometriosis. Cervical cytology is usually negative. Preoperative diagnosis requires deep cervical biopsy. No guidelines regarding optimal treatment exists; radiotherapy, chemotherapy, and surgery are used in different combinations. Conservative treatment with the combination of surgery and chemotherapy or surgery and radiotherapy has been reported in a few cases with apparent success. With this review, we aim to understand what the best therapeutic approaches for this rare pathology in young and elderly women are. Moreover, we find favorable pregnancy outcome in patients treated with a fertility sparing approach.

Funder

Italian Ministry of Health

Maternal and Child Health IRCCS Burlo Garofolo—Trieste, Italy

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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