Synchronous multiple primary cancers involving cervical cancer and follicular lymphoma - A case report

Sep 23, 2026

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Multiple primary cancers denotes two or more histologically distinct tumor types occurring simultaneously or sequentially. This case report presents a rare instance of a 46-year-old female simultaneously diagnosed with cervical cancer and low-grade follicular lymphoma. Vaginal bleeding led to cervical biopsy confirming cervical squamous cell carcinoma, while imaging suggested para-aortic lymph node metastasis. Laparoscopic radical hysterectomy with lymph node dissection was performed, and postoperative pathology identified primary follicular lymphoma rather than metastatic disease. The case highlights surgical value for distinguishing metastasis from a second primary malignancy in isolated para-aortic node enlargement.

LanguageEnglish

CategoryHealthcare

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Abstract

Introduction

Case report

ONCOLOGY LETTERS 29: 183, 2025 Synchronous multiple primary cancers involving cervical cancer and follicular lymphoma: A case report SHIYUE LIU 1* , HANYU2* , HONG LI3 , YOUHONG DONG 1 and DONGDONG ZHANG 1 1Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China; 2 Department of Pathology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China; 3Department of Rehabilitation Medicine, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China Received September 22, 2024; Accepted January 15, 2025 DOI: 10. 3892/ol.2025.14930 Abstract. Multiple primary cancers refers to the occurrence of two or more histologically distinct tumor types, either simul‑ taneously or sequentially. The present report describes a rare case of a 46‑year‑old female patient simultaneously diagnosed with cervical cancer and low‑grade follicular lymphoma (FL) . The patient presented with vaginal bleeding and a subsequent cervical biopsy confirmed cervical squamous cell carcinoma. Imaging examinations indicated suspicious para‑aortic lymph node metastasis, leading to a laparoscopic radical hysterectomy with lymph node dissection. Postoperative histopathological examination revealed cervical squamous cell carcinoma . However, para‑aortic lymph node metastasis was not observed and instead, primary FL was detected. The current case underscores the importance of surgical intervention in cases where cervical cancer presents with isolated para‑aortic lymph node enlargement, as it is essential for distinguishing between lymph node metastasis and the presence of a second primary tumor. Introduction The incidence of multiple primary cancers (MPC) is rising in the general population (1) and accounts for 2‑17% of all cancer Correspondence to: Dr Youhong Dong or Dr Dongdong Zhang, Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, 15 Jiefang Road, Xiangyang, Hubei 441000, P.R. China E‑mail: [dongyouhong2005@163.com](dongyouhong2005@163.com) E‑mail: [zhangdongdong@whu.edu.cn](zhangdongdong@whu.edu.cn) *Contributed equally Abbreviations: MPC, multiple primary cancers; FL, follicular lymphoma; HPV, human papillomavirus; NCCN, National Comprehensive Cancer Network Key words: MPC, cervical cancer, FL, isolated para‑aortic lymph node enlargement cases (2,3) . The pathogenesis of MPC is complex and multi‑ factorial. The pathogenesis involves genetic susceptibility, environmental exposures, lifestyle factors, immune system abnormalities and treatment‑related side effects (4) . Due to the rarity and complexity of MPC, available data and literature are limited, leading to a lack of unified guidelines and consensus on its diagnosis and treatment. Accurate histopathological classification and staging of MPC are crucial, as they provide the foundation for individualized treatment strategies tailored to each tumor type (5) . This approach helps address the chal‑ lenges posed by MPC and improves treatment outcomes and quality of life of patients. Cervical cancer is one of the most prevalent malignan‑ cies of the female reproductive system, and the incidence of synchronous double primary malignancies in patients with cervical cancer is relatively low (6) . According to the litera‑ ture, cervical cancer may coexist with various other cancer types, including endometrial, ovarian, breast, colorectal and lung cancer (6‑8) . However, the simultaneous occurrence of primary lymphoma in patients with cervical cancer is exceed‑ ingly rare. The present report aims to highlight a rare case involving a 46‑year‑old female patient diagnosed with dual primary malignancies: Cervical cancer and FL. The specific objective of this case report is to address the diagnostic chal‑ lenges and clinical significance encountered when evaluating cervical cancer patients with isolated para‑

FAQs

What does multiple primary cancers mean in this report?

Multiple primary cancers refers to two or more histologically distinct tumor types that occur either simultaneously or sequentially.

How was the patient’s cervical cancer diagnosed?

Vaginal bleeding prompted cervical biopsy, which confirmed cervical squamous cell carcinoma.

Why was surgery important when para-aortic lymph node enlargement was present?

Surgical intervention helped distinguish para-aortic lymph node metastasis from the presence of a second primary tumor, which directly affects treatment decisions and outcomes.

Sep 23, 2026

Uploaded by Noah