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449 Invasive cervical cancer and pregnancy: a case report and review of the literature
  1. Mohamed Abdellahi El El Moctar,
  2. Hanane Taghzouti,
  3. Sara Boudhas,
  4. MB Idrissi,
  5. KM Saoud,
  6. N mamouni,
  7. S Errarhay,
  8. C Bouchikhi and
  9. A Banani
  1. Obstetrics Gynecology I Department of the CHU HASSAN II, Faculty of Medicine, Sidi Mohamed Ben Abdellah University, Fès, Morocco

Abstract

Introduction/Background The incidence of dysplasia during pregnancy is estimated at 1%, and that of cervical cancer at one in 10,000. Cervical cancer is one of the most frequently observed cancers during pregnancy.the objectives are twofold and sometimes antagonistic: to achieve a level of care that is closer to that of non-pregnant patients, and if possible, to maintain the pregnancy. but recent publications report cases of pregnancy preservation. This must not be to the detriment of the carcinological result.

Methodology Patient aged 39, with a history of recurrent post-coital metrorrhagia for 04 years, neglected by the patient, admitted to the emergency department for delivery of a full-term pregnancy, with clinical examination revealing an ulcerating-bourging tumour of the uterine cervix. a caesarean section was performed, and cervical sampling confirmed the diagnosis of squamous cell carcinoma

Results The median age of parturients found in the literature was 38 years with extremes of 35 and 42 years and the average clinical size of lesions was 3 cm in diameter in our patient the size of the lesion was 06 cm, Anatomopathological examination showed squamous cell carcinoma. The disease was classified according to the FIGO 2009 classification as IIIB. Treatment consisted of RCC (concomitant radiochemotherapy) after the emergency caesarean section.

Conclusion In parturients who have had little or no screening for more than two years, a Pap smear should be taken at the start of pregnancy to detect cervical abnormalities and to make patients aware of the benefits of screening. For dysplastic lesions in the absence of colposcopically-proven invasion, treatment can be deferred to the post-partum period, with close monitoring. In the case of invasive lesions, the work-up should be completed by MRI to better define the size of the lesion. Management will depend on term, stage of lesion and lymph node involvement.

Disclosures Authors declare no conflict of interest.

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