Primary B-Cell lymphoma of the uterine cervix presenting with right ureter hydronephrosis: A case report

Abstract

Primary lymphoma of the uterine cervix is a very infrequent disease, usually affecting perimenopausal women. Symptoms are very similar to other gynecological malignancies, but treatment and prognosis completely differ, as most of these patients have a better survival. This condition has to be suspected in women with recent normal Pap smear test, rapidly growing tumor and initially non-contributory biopsies. We report a case of primary diffuse large-B-cell lymphoma of the uterine cervix mimicking a locally advanced cervical cancer with right ureter hydronephrosis at diagnosis. She was medically managed with a combination of rituximab and chemotherapy with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone, associated to methotrexate for central nervous system prophylaxis. We will discuss about the role of combined treatments with surgery and radiotherapy, and the fertility sparing management in young women.

Keywords: Female genital tract lymphoma; Hydronephrosis; Non-Hodgkin's lymphoma; Pelvic mass differential diagnosis; R-CHOP regimen; Uterine cervix lymphoma.