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233 Gynecological malignancies in emergency department
  1. Y Onishi,
  2. T Miyakawa,
  3. M Minematsu,
  4. S Natsuaki and
  5. M Ogawa
  1. Fukuoka Tokushukai Hospital, Japan


An oncologic emergency may be defined as any acute potentially morbid or life-threatening event directly or indirectly related to a patient‘s tumor or its treatment. Occasionally, these emergent conditions may be the presenting symptom of a previously undiagnosed neoplasm.

Our hospital have the emergency departments(ED) covering about one million population in the medical area, and accept bout 20,000 patients a year. In ED, some female patient show the critical symptom caused by gynecological malignancies undiagnosed.

Methods We review the clinical data of emergent gynecologic malignancies in 2016,17,18 and 2019.

Results We had 21 patients with gynecological malignancies. In those patients, 12 patients were ovarian cancer with acute abdominal pain caused by tumor torsion or rupture.

Four patients were endometrial cancer. One of those had brain metastasis and operated by brain surgeon.

Five cervical cancer patients complained various symptoms as general fatigue, renal failure, chronic severe anemia, acute abdomen, shock with genital bleeding. Two patients had emergent ureter catheterization because of the severe renal failure. One patient with acute abdomen had omentum metastasis from cervical squamous cancer(Reported in 2019IGCS).

Conclusions Emergent female cancer patients need gynecological oncological care in ED. For ovarian and endometrial cancer, screening and prevention is not established. But cervical cancer is one of the preventable disease by screening and vaccination. Unfortunately, we still have the critical advanced cervical cancer patients. In Japan, we have no nation-wide vaccination program and PAP screening rate is only 40%. We re-emphasize the urgent establishment of nation-wide program of vaccination and screening for cervical cancer.

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