Objectives To describe the case of a patient with a diagnosis of cervical adenocarcinoma in the 2nd trimester of gestation, where it was decided to maintain the pregnancy and perform chemotherapy until the end of gestation, where the final surgical treatment was performed.
Methods We present a case of a woman diagnosed with adenocarcinoma of the cervix during pregnancy, with maintenance of chemotherapy during pregnancy and puerperal surgery.
Results 40-year woman, presented at 18 weeks; referred to evaluation of a colposcopist due vaginal bleeding. A cervix lesion, measuring 30 mm, well differentiated invasive endocervical adenocarcinoma. The tumor was classified as stage IB1 (FIGO). The patient received neoadjuvant chemotherapy with 4 cycles of cisplatin every 3 weeks. No obstetric complications during pregnancy; a new MRI at 32 weeks, without significant changes in tumor size. Fetal growth assessment was evaluated every 2 weeks; cesarean section at 34 weeks. After the cesarean section underwent radical hysterectomy with pelvic lymphadenectomy.We need to perform bilateral clamping of the uterine arteries prior to pelvic lymphadenectomy due to excessive bleeding.
Conclusions The use of cisplatin as drug of choice for neoadjuvant chemotherapy for IB1 adenocarcinoma cervical cancer was safe for the fetus, which did not present malformations or intrauterine growth restriction. Regarding postpartum surgery, clamping of the uterine arteries prior to pelvic lymphadenectomy and radical hysterectomy decreased intraoperative blood loss and did not compromise the final outcome with regard to: surgery operation time, surgical margin, and patient recovery. According to literature, breastfeeding should be discouraged in patients undergoing treatment with cisplatin.
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