Document Detail

First case of vaginal radical trachelectomy in a pregnant Japanese woman.
MedLine Citation:
PMID:  21416240     Owner:  NLM     Status:  MEDLINE    
A diagnosis of cervical cancer during pregnancy poses difficult management and ethical problems. Survival of the patient is the foremost concern, but fetal viability and well-being must also be addressed. Radical trachelectomy (RT) has recently begun to be performed as a possible treatment modality for early stage invasive uterine cervical cancer in pregnant patients who would like to continue their pregnancy. A 32-year-old Japanese woman visited a local hospital for prenatal care, and was diagnosed with a FIGO I B1 adenocarcinoma of the uterine cervix. She had a strong desire to avoid pregnancy termination, so she was admitted to our hospital for fertility-preserving surgery. After extensive counseling, vaginal radical trachelectomy with abdominal pelvic lymphadenectomy was performed in the 16th gestational week. The excised uterine cervix and lymph nodes were pathologically negative for cancer. To maintain her pregnancy, daily vaginal disinfection with povidone iodine, bed rest, and administration of ritodrine and an ulinastatin vaginal suppository were continued until the delivery. At 34 weeks' gestation, an emergency cesarean section was performed because of sudden premature rupture of the membranes. A baby girl was born weighing 2112 g, with Apgar score of 8/9. The mother remains without evidence of recurrence at the time of this report. This is the first case of successful pregnancy and delivery in Japan after vaginal RT.
Nanako Iwami; Shin-ichi Ishioka; Toshiaki Endo; Tsuyoshi Baba; Kunihiko Nagasawa; Madoka Takahashi; Asuka Sugio; Sakura Takada; Tasuku Mariya; Masahiro Mizunuma; Tsuyoshi Saito
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2011-03-18
Journal Detail:
Title:  International journal of clinical oncology     Volume:  16     ISSN:  1437-7772     ISO Abbreviation:  Int. J. Clin. Oncol.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-14     Completed Date:  2012-05-15     Revised Date:  2012-12-13    
Medline Journal Info:
Nlm Unique ID:  9616295     Medline TA:  Int J Clin Oncol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  737-40     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Sapporo Medical University, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido 064-8453, Japan.
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MeSH Terms
Adenocarcinoma / diagnosis,  pathology,  surgery*
Cesarean Section
Gynecologic Surgical Procedures
Infant, Newborn
Lymph Node Excision
Neoplasm Staging
Pregnancy Complications, Neoplastic / pathology,  surgery*
Uterine Cervical Neoplasms / diagnosis,  pathology,  surgery*

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