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Villoglandular adenocarcinoma of the cervix recurrent in an episiotomy scar: a case report in a 32-year-old female
  1. D. E. Heron*,
  2. A. Axtel,
  3. K. Gerszten*,
  4. A. Amortegui,
  5. J. Kelley,
  6. J. Comerci and
  7. R. P. Edwards§
  1. * Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  2. Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  3. Division of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  4. § Department of Gynecologic Oncology University of Kentucky, Louisville, Kentucky


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

  • cervix
  • episiotomy scar
  • villoglandular adenocarcinoma

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