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EP395 The patient had stage IIIB cervical carcinoma with pregnancy has followed up without disease for 22 years: case report
  1. M Sahin,
  2. SA Ergen and
  3. I Sahinler
  1. Radiation Oncology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey

Abstract

Introduction/Background Cervical carcinoma is the most common gynecological malignancy during pregnancy. The incidence is expected to increase due to the fact that women delay childbearing. In this case report, we present a patient diagnosed with cervical carcinoma during 6 weeks pregnancy.

Methodology A 39 years old woman (gravida 6, para 3) presented with the left groin and lower back pain in 1996. She was diagnosed with FIGO Stage IIIB squamous cell cervical carcinoma and also she was six weeks pregnant surprisingly. It was requested that the pregnancy be terminated by curettage, but cervical os couldn’t be dilated. She was referred to our clinic for radiotherapy. In the abdomino-pelvic computed tomography, the cervix uteri was enlarged diffusely to 43 × 70 mm, there was parametrial invasion with surrounding the left ureter and it was diagnosed with grade 2 hydronephrosis. The chest X-Ray was found normal. According to rectovaginal examination, there was endophytic, bleeding mass in cervix uteri and left parametrial involvement up to pelvic side wall. The external beam radiotherapy was applied to pelvis with a total dose of 54 Gy (1.8 Gy fraction dose). In the third weeks, the tumor had regressed more than 50% and the parametrial involvement had regressed almost completely. The uterine cavity was curetted before intracavitary radiotherapy (ICRT). ICRT was applied with tandem and ovoids and the prescribed dose was 24 Gy in 3 fractions to A point.

Results In gynecological examination after the treatment was completed, the total regression was observed. The patient has been followed up regularly for 22 years without recurrence or metastasis.

Conclusion The patients with the cervical carcinoma during pregnancy are usually diagnosed at earlier stages. According to our literature review, this is the only patient with long term survival despite having stage IIIB cervical carcinoma.

Disclosure Nothing to disclose.

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