Clinical outcome of pulmonary lymphangitic carcinomatosis in gynecologic malignancy: A single-institution experience

Pulmonary lymphangitic carcinomatosis (PLC) is a rare event of metastatic lung disease in advanced gynecologic malignancy. Nonspecific symptoms of patients and difficulties in detection of PLC often result in a delayed diagnosis. In this study, we evaluated the clinical outcomes of PLC in patients with gynecologic cancer.We retrospectively reviewed electronic medical records of patients with gynecologic cancer who received care from January 1, 2008 through December 31, 2018 in Samsung Medical Center, Seoul, Republic of Korea. We based diagnosis of PLC on chest CT scan and analyzed clinical parameters of cancer type, International Federation of Gynecology and Obstetrics (FIGO) stage, histology, and patient survival.During the study period, 27 cases of PLC in patients with gynecologic malignancy were identified, including 11 cervical, 12 ovarian, and four uterine cancers. The most common histologic type at initial diagnosis was squamous cell in cervical (6/11, 55%), serous in ovarian (1/11, 92%), and serous in endometrial (2/4, 50%) cancer. The average survival time from diagnosis of PLC to death was a mean of 5.7 months (0.7-23.6 months) in all patients and 6.3, 6.6, and 3.6 months for cervical, endometrial, and ovarian cancer, respectively.This study showed that PLC results in extremely poor survival, from several days to a few months, in patients with gynecologic cancer. Clinicians must be aware of these clinical characteristics and consider other novel therapeutic strategies in the future.