Geburtshilfe Frauenheilkd 2014; 74 - PO_Onko10_06
DOI: 10.1055/s-0034-1388503

Ovarian cancer as a correlation to PAP V

L Anastasiadou 1, K Kelling 1, M Schneider 1, C Schulze 1, B Welter 2, D Klimas 3, C Heinrichs 4, H Motherby 4, C Brandi 1, M Thill 1, J Barinoff 1
  • 1Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany
  • 2Praxis für Gynäkologie und Geburtshilfe, Frankfurt am Main, Germany
  • 3Zytologisches Institut, Pulheim, Germany
  • 4Institut für Pathologie, Frankfurt am Main, Germany

Purpose: A cervical screening detects not only cervical dysplasia and cervical cancer. Furthermore it can be in very rare cases a detector of an adenocarcinoma of the ovary. PAP V as a result refurs generally to an invasive cancer. After excluding histologically a cervical and endometrial cancer, ovarian cancer needs to be considered as a differential diagnosis.

Patients and methods: A 71-year old patient with a PAP V smear (cells of adenocarcinoma) underwent a hysteroscopy, fractionated curettage, a-four-quadrant-cervical biopsy, vaginal assessment and cystoscopy. No evidence of cancer cells was found. The smear test after three months showed a PAP IIk. Three months later a laparoscopy was performed on the patient because of a bilateral inguinal hernia. Peritoneal carcinosis and ascites caused from an adenocarcinoma of the ovary turned up as secondary findings.

Results: After ovarian cancer has been histologically diagnosed, the patient underwent a cytoreductive surgery with total abdominal hysterectomy, bilateral salpingoopherectomy, total omentectomy, resection of sigmoid colon, peritonectomy with right diaphragmatic resection, pelvic and aortic lymphonodectomy and excision of a left inguinal lymphnode and laparoscopy channels. The ovarian serous-papillary carcinoma, FIGO IV (abdominal wall and inguinal lymphnode) has been optimally debulked with no residual disease.

Conclusion: According to literature sources, some similar cases have been reported. A PAP smear V with cells of adenocarcinoma finding indicates an invasive cancer. Adenocarcinoma of the endocervical canal, endometrium, extrauterine, ovary and others should be considered and histologically proven as the proper staging procedures need to be done and the appropriate treatment followed.