Human papillomavirus detection and genotyping on pelvic nodes in patients with synchronous gynecological malignancies: a tool for identifying the primary site of lymphatic spread?

INTRODUCTION

Synchronous gynecological tumors are uncommon. Identifying the primary site of lymphatic spread may be difficult.

METHODS

Two women with synchronous squamous cervical and adenosquamous endometrial cancers (patient A) and squamous cervical and serous borderline ovarian tumors (patient B) entered retrospectively this study. Both patients had pelvic nodal metastases of unknown origin. Uterine cervix, endometrium, and lymph nodes were tested for human papillomavirus DNA using high-sensitive polymerase chain reaction, followed by oligonucleotide microarray for genotyping.

RESULTS

Human papillomavirus 16 DNA was extracted from portio vaginalis and pelvic nodes of both women. Viral homology between cervical and lymph nodal lesions helped to identify the primary metastasizing tumors in both patients.

CONCLUSIONS

Human papillomavirus testing on pelvic lymphatic tissue represents a feasible tool to detect the primary site of lymphatic spread in synchronous gynecological malignancies, when uterine cervix is involved.