Document Detail


Neoadjuvant cisplatin and radical cesarean hysterectomy for cervical cancer in pregnancy.
MedLine Citation:
PMID:  17534393     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A 28-year-old Hispanic gravida 1 was found to have a 4-5 cm cervical mass when she presented at 23 weeks gestation. On pelvic examination, the tumor was shown to encompass the entire circumference of the cervix without parametrial or vaginal involvement. A biopsy of the mass revealed a poorly differentiated squamous-cell carcinoma of the cervix. An MRI study of the abdomen and pelvis showed a 4 cm cervical mass that was suspicious for left parametrial and rectovaginal septal involvement. No hydronephrosis or lymphadenopathy was noted. The patient elected to proceed with her pregnancy. INVESTIGATIONS: General physical and gynecological examinations, cervical biopsy, pelvic and obstetric ultrasound, histopathological examination, MRI of the abdomen and pelvis without and with gadolinium, neonatal hearing test and renal function studies. DIAGNOSIS: Poorly differentiated stage IB2 squamous-cell carcinoma of the cervix with MRI imaging suggestive of parametrial and rectovaginal septal involvement. MANAGEMENT: Neoadjuvant chemotherapy using weekly cisplatin from 24 to 30 weeks, bed rest and oral terbutaline at 31 weeks because of premature contractions, and a course of antenatal steroids to promote fetal lung maturity. At 33 weeks radical cesarean hysterectomy, bilateral pelvic and para-aortic lymphadenectomy and bilateral ovarian transposition were carried out, followed by adjuvant pelvic radiation therapy with cisplatin chemosensitization 4 weeks postpartum.
Authors:
Amer Karam; Nancy Feldman; Christine H Holschneider
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Nature clinical practice. Oncology     Volume:  4     ISSN:  1743-4262     ISO Abbreviation:  -     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-30     Completed Date:  2007-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101226509     Medline TA:  Nat Clin Pract Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  375-80     Citation Subset:  IM    
Affiliation:
UCLA/Cedars-Sinai Gynecologic Oncology fellowship program, Los Angeles, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Agents / therapeutic use*
Carcinoma, Squamous Cell / therapy*
Cesarean Section
Cisplatin / therapeutic use*
Female
Humans
Hysterectomy*
Neoadjuvant Therapy
Pregnancy
Pregnancy Complications, Neoplastic / therapy*
Treatment Outcome
Uterine Cervical Neoplasms / therapy*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 15663-27-1/Cisplatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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