Villoglandular adenocarcinoma of the cervix recurrent in an episiotomy scar: a case report in a 32-year-old female

Int J Gynecol Cancer. 2005 Mar-Apr;15(2):366-71. doi: 10.1111/j.1525-1438.2005.15231.x.

Abstract

Cervical cancer during pregnancy is rare, occurring in approximately 3% of cervical cancer cases. Considerable controversy exists as to the long-term prognosis of patients diagnosed during pregnancy. A 32-year-old female presented with vaginal spotting in April 1998. A prenatal smear in December 1996 revealed atypical glandular cells of undetermined significance. A sterile speculum exam in April 1997 at 31-week gestational age revealed a polyp on the anterior lip of the cervix, pathology consistent with a well-differentiated villoglandular adenocarcinoma. In August 1997, the patient underwent a radical hysterectomy with pelvic/para-aortic lymphadenectomy. In April 2001, she represented with nodular perineal mass in the episiotomy incision. She received preoperative radiotherapy with a near-complete response and remained without disease for >10 months. It appears that a less radical procedure can offer significant therapeutic value. Preoperative radiotherapy proved effective at achieving a near-complete response. The patient underwent a wide local excision of the perineal area with resultant negative margins.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / surgery*
  • Adult
  • Episiotomy / adverse effects*
  • Female
  • Humans
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local*
  • Perineum / pathology
  • Perineum / surgery
  • Pregnancy
  • Pregnancy Complications, Neoplastic / pathology*
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / radiotherapy
  • Uterine Cervical Neoplasms / surgery*