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EP1262 Cervical cancer during pregnancy and diagnostic problems – a case report
  1. A Słabuszewska-Jóźwiak1,
  2. M Janicka2,
  3. K Zaręba1,
  4. J Szymański1 and
  5. G Jakiel1
  1. 1The First Department of Obstetrics and Gynecology, Medical Centre of Postgraduate Education, Warsaw
  2. 2Żelazna Medical Center, Warszawa, Poland

Abstract

Introduction/Background An invasive cervical cancer discovered during pregnancy is a rare clinical feature. However, this is one of the most common malignancies occurring during pregnancy. The prevalence according to population ranges is estimated between 1 and 10 for 10,000 pregnancies. Diagnostics in pregnant women are similar to those in non-pregnant women, including colposcopy and Pap smear. We report a case of pregnant patient with advance cervical cancer treated by radical surgery and chemoradiotherapy.

Methodology Case report

Results 32 -years-old pregnant woman, with no significant medical history, with no history of vaginal blooding and a low grade squamous intraepithelial lesion in Pap smear (LSIL) was admitted to the First Department of Obstetrics and Gynaecology at 38 weeks‘ gestation. A colposcopy and a cervical biopsy during pregnancy confirmed a cervical intraepithelial neoplasia grade 1 (CIN1). At the admission, a physical examination performed a lesion located in proximal part of cervix that suggested leyomyoma. An ultrasonographic examination showed the presence of hipervasculr and limited cervical tumour. Both lateral parametria were not involved. Because of uncertain diagnosis at 39 weeks‘ gestation a caesarean section was performed. A tumour biopsy revealed a low differentiated squamous cell carcinoma. Abdominal radical hysterectomy and pelvic lymphadenectomy with adnexal transposition was performed. The final pathological result showed presence of a low differentiated cervical carcinoma and macro metastasis in 2 pelvic lymph nodes. An adjuvant chemoradiotherapy was proposed

Conclusion Physiological pregnancy changes make Pap smear and colposcopy difficult to interpret therefore such patients should be followed in specialized centres. However, expert ultrasound examination should be consider as routine examination.

Disclosure Nothing to disclose

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