Synchronous Ovarian and Cervical Malignancies: A Case Report of Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery and Niraparib Maintenance.

PURPOSE: The coexistence of ovarian carcinosarcoma, contralateral high-grade serous ovarian carcinoma, and synchronous cervical squamous cell carcinoma as multiple primary gynecologic malignancies is exceedingly rare. The tumor biology of such synchronous multiple primary malignancies (MPMNs), including pathogenesis, disease progression and prognostic impact, is not well established. PATIENTS AND METHODS: Here we report the case of a 66-year-old woman diagnosed with distinct tumors: left ovarian carcinosarcoma, right ovarian high-grade serous carcinoma, and cervical squamous cell carcinoma, and review the literature on multiple primary malignancies (MPMNs). RESULTS: Following preoperative neoadjuvant chemotherapy with three cycles of paclitaxel plus carboplatin, the patient achieved a significant reduction in tumor volume and underwent interval cytoreductive surgery. After that, she received five cycles of adjuvant chemotherapy: two cycles of paclitaxel plus carboplatin (with bevacizumab added in the second cycle), followed by three cycles of paclitaxel plus cisplatin. Despite testing negative for HRD and BRCA mutations, she subsequently received maintenance therapy with niraparib. This treatment led to a progression-free survival of nearly one year. Although her ovarian cancer later recurred, her overall survival exceeded three years. CONCLUSION: Multiple primary malignant neoplasms (MPMNs) are rare and there are no unified clinical guideline for this situation. This report is valuable for enhancing clinical recognition of this rare condition and contributes to optimizing and personalizing MPMNs care.