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305 Individualized treatment of HPV-associated synchronous vulvar and cervical cancer. A case report
  1. Beata Vida,
  2. Agnes Kover,
  3. Zoltan Tandor,
  4. Emese Hajagos,
  5. Szabolcs Molnar and
  6. Zoard Tibor Krasznai
  1. University of Debrecen, Debrecen, Hungary

Abstract

Introduction/Background Synchronous cervical and vulvar cancer refers to a relatively rare medical condition. Most often these distinct primary cancers are associated with the human papillomavirus (HPV), particularly certain high-risk subgroups. However, the development of synchronous cancers is not solely attributed to HPV but can be influenced by epigenetic and genetic factors. Treatment options may include surgery and concomitant chemoradiotherapy, therapeutic decision depends on the stage and extent of the synchronous diseases, as well as the patient‘s overall preferences regarding family planning.

Methodology We present a case of a young patient with synchronous vulvar and cervical cancer.

Results In the previous history of the 32-year-old patient high-risk HPV associated cervical dysplasia could be found. She was referred with a right-sided enlarged vulvar lesion to our department. Vulvar biopsy confirmed the presence of squamous cell cancer, imaging tests suggested early stage vulvar cancer associated with a histologically not verified cervical malignancy. Radical vulvectomy and bilateral inguinal lymphadenectomy were performed with cervical loop excision. Based on histological findings vulvar cancer was completely removed, yet invasive cervical cancer was identified. Considering the age and the family planning of the patient, cold knife conisation was performed. Owing to the rapid progression of cervical malignancy, postoperative imaging scans proved locally advanced stage of cancer. Based on tumor board decision making concomitant chemoradiotherapy was applied in order that the extent of cervical malignancy could be decreased.

Post-treatment physical examination and imaging registered favourable results.

Conclusion Synchronous cervical and vulvar cancer is a challenging medical condition that necessitates a comprehensive and individualized approach for evidence-based treatment. Patients diagnosed with synchronous malignancies should work closely with their medical team to develop a personalized treatment plan that addresses their unique needs and circumstances.

Disclosures The authors have no conflict of interest.

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