子宮頸がんの無症候性再発の胃転移としての提示：稀な症例報告

Gastric metastasis from cervical cancer is exceedingly rare, with limited data to guide diagnosis and management. Reported cases are typically associated with widespread disease and poor prognosis. We present the case of a 56-year-old woman with stage IIIA squamous cell carcinoma of the cervix. She was initially treated with cisplatin-based chemoradiation followed by interstitial brachytherapy. Surveillance imaging identified a new gastric antral mass. Endoscopic biopsy confirmed metastatic squamous cell carcinoma consistent with the cervical primary. PET/CT revealed isolated gastric and right parametrial involvement. She was started on carboplatin and paclitaxel, but progressed to partial gastric outlet obstruction. She subsequently received palliative external beam radiation to the gastric lesion (37.5 Gy in 15 fractions) and was started on pembrolizumab based on strong programmed death-ligand 1 (PD-L1) expression (combined positive score (CPS) of 100). Despite treatment, she experienced further clinical and radiographic progression. Her condition continued to worsen, leading to hospitalization with multiple complications. She ultimately succumbed to her illness approximately one year after diagnosis. This case highlights the clinical challenges of managing gastric metastasis as a site of recurrence following definitive treatment for cervical cancer. Although a multimodal approach incorporating chemotherapy, radiation, and immunotherapy was employed, the patient experienced disease progression. Early detection and symptom-directed local therapies may offer temporary benefit; however, outcomes remain poor, and data on overall survival in this setting are extremely limited. As systemic therapies improve survival in advanced cervical cancer, awareness of atypical metastatic patterns such as gastric involvement will become increasingly important in guiding surveillance and treatment strategies.