case_images: PMC10956574_01
case_images: Morphology of cervical lesions. (A) Colposcopy examination of the cervical lesions. Red arrows indicate the cervical lesions. (B) Vinegar test: opaque white spots with the white color fading slowly and presence of mosaic blood vessels. (C) Cervical iodine test result: no change in color in the iodine test of the anterior cervical lip.
case_images: fonc-14-1298109-g001.jpg
case_images: PMC10956574_01_fonc-14-1298109-g001.jpg
case_images: f1
case_images: Colposcopy revealed erosion-like changes in the anterior cervical lip, vascular proliferation, and bleeding after contact ( Figure 1A ). Figure 1B ), with no change in color in the iodine test ( Figure 1C ). Full abdominal + pelvic magnetic resonance imaging showed a cervical mass of approximately 2.6 cm in the maximum diameter ( Figure 2A ); a nodular mass on the right side of the pelvis, which was considered a metastatic lesion ( Figure 2B ); multiple space-occupying lesions in the abdominal cavity ( Figure 2C ); and enlarged retroperitoneal lymph nodes ( Figure 2D ), also considered to be metastatic lesions.
case_images: Full abdomen + pelvis magnetic resonance imaging. (A) Anterior cervical lip with a slightly enhanced signal on T2-weighted images, approximately 26 mm in diameter. (B) Enhancement of the right pelvic nodal lesion (red arrow) on T1-weighted images. (C) Enhanced signal of the mass in the right upper abdomen (red arrow) on diffusion-weighted images. (D) Enlarged retroperitoneal abdominal para-aortic lymph nodes (red arrow) on diffusion-weighted images.
case_images: fonc-14-1298109-g002.jpg
case_images: PMC10956574_01_fonc-14-1298109-g002.jpg
case_images: f2
case_images: Figure 1B ), with no change in color in the iodine test ( Figure 1C ). Full abdominal + pelvic magnetic resonance imaging showed a cervical mass of approximately 2.6 cm in the maximum diameter ( Figure 2A ); a nodular mass on the right side of the pelvis, which was considered a metastatic lesion ( Figure 2B ); multiple space-occupying lesions in the abdominal cavity ( Figure 2C ); and enlarged retroperitoneal lymph nodes ( Figure 2D ), also considered to be metastatic lesions.
case_images: Positron emission tomography-computed tomography. (A) Nodular lesion anterior to the hepatic flexure of colon. (B) Enlarged retroperitoneal abdominal para-aortic lymph nodes. (C) Multiple soft-tissue masses and nodules on the right wall of the pelvis.
case_images: fonc-14-1298109-g003.jpg
case_images: PMC10956574_01_fonc-14-1298109-g003.jpg
case_images: f3
case_images: Positron emission tomography-computed tomography showed space-occupying lesions in the cervix; multiple soft-tissue masses and nodules anterior to the hepatic flexure ( Figure 3A ), adjacent to the greater curvature of the stomach, retroperitoneal and adjacent to the abdominal aorta ( Figure 3B ), and on the right wall of the pelvis ( Figure 3C ); and abnormally elevated glucose levels.
case_images: (A) Intraoperative observation of a neoplasm of approximately 3.0 cm in size in the right ovary, (B) Uterine specimen: The tumor is found in the cervical canal, with a diameter of 2+ cm and a nodular shape.
case_images: fonc-14-1298109-g004.jpg
case_images: PMC10956574_01_fonc-14-1298109-g004.jpg
case_images: f4
case_images: Intraoperatively, the right ovary showed a neoplasm of approximately 3.0 cm ( Figure 4A ). Postoperative dissection of the uterine specimen revealed a tumor approximately 2+ cm in diameter and nodular in shape located in the cervical canal ( Figure 4B ).
case_images: Pathologic findings: (A) Hematoxylin and eosin (HE) staining of the nonkeratinizing SCC of the cervix. (B) Hematoxylin and eosin staining of the HGSOC. (C) hematoxylin and eosin staining of the enlarged lymph nodes adjacent to the abdominal aorta. The SCC area had a nest-like distribution of the tumor cells, patchy necrosis, pathological karyorrhexis, and invasive growth. Immunohistochemistry: tumor cells in the SCC of the cervix were diffusely positive for (D) CK5/6, (E) p16, (F) Ki-67, and (G) p40, and the tumor cells in the HGSOC were diffusely positive for (H) CA125, (I) WT-1, (J) Pax-8, and (K) p53.
case_images: fonc-14-1298109-g005.jpg
case_images: PMC10956574_01_fonc-14-1298109-g005.jpg
case_images: f5
case_images: Figure 5A ), with the tumor infiltrating nearly the entire layer (> three-fourths) and cervical canal and lympho-vascular and perineural invasions. Furthermore, the right ovarian neoplasm was HGSOC ( Figure 5B ). Immunohistochemical examinations showed CK5/6 (+;  Figure 5C ), p16 (+;  Figure 5D ), Ki-67 (+; approximately 80%;  Figure 5E ), and p40 (+;  Figure 5F ) in the cervical tumor tissue. Pax-8 (+;  Figure 5H ), p53 (strongly diffused +;  Figure 5I ), p16 (+), CK7 (partially +), CD1 (-), CK2O (-,  Figure 5J ), CDX-2 (-), and Ki-67 (+, approximately 80%). Postoperative diagnoses were stage IIIC2 HGSOC and stage IB2 nonkeratinizing SCC of the cervix.
case_images: Timeline of the patient.
case_images: fonc-14-1298109-g006.jpg
case_images: PMC10956574_01_fonc-14-1298109-g006.jpg
case_images: f6
case_images: The timeline of the patient's entire treatment process was depicted in  Figure 6 .