Document Type : Case Report

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Gynecologist Oncologist, Fellowship of Gynecology Oncology, Mashhad, Iran

4 Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Squamous cell carcinoma is one of the common malignancies among women, especially in the third and fourth decades of life. Human papillomavirus is the most important cause of squamous cell carcinoma among women worldwide. Early diagnosis and treatment of this carcinoma can prevent disease progression. Herein, we present the case of a pregnant woman with squamous cell carcinoma. A 35-year-old pregnant woman referred to our clinic for cervical cerclage. During the procedure, the gynecological surgeon observed a suspicious lesion. Accordingly, cervical conization was performed and a squamous cell carcinoma lesion was confirmed by the pathology reports. Neoadjuvant chemotherapy was initiated for the patient during pregnancy. Radical hysterectomy and bilateral lymphadenectomy were conducted toward caesarean section. As the patient was a young fertile woman, the ovaries were saved. Although chemotherapy is not a standard treatment for cervical cancer in pregnancy, but neoadjuvant chemotherapy followed by radical hysterectomy and bilateral pelvic lymphadenectomy during cesarean section was a successful treatment in our patient.

1.         Hecking T, Abramian A, Domröse C, Engeln T, Thiesler T, Leutner C, et al. Individual management of cervical cancer in pregnancy. Arch Gynecol Obstet. 2016;293(5):931-9.
2.         Mocarska A, Starosławska E, Zelazowska-Cieślińska I, Łosicki M, Stasiewicz D, Kieszko D, et al. Epidemiology and risk factors of the cervical squamous cell carcinoma. [Article in Polish] Pol Merkur Lekarski. 2012;33(194):101-6.
3.         Hiniker SM, Roux A, Murphy JD, Harris JP, Tran PT, Kapp DS, et al. Primary squamous cell carcinoma of the vagina: prognostic factors, treatment patterns, and outcomes. Gynecol Oncol. 2013;131(2):380-5.
4.         Gadducci A, Fabrini MG, Lanfredini N, Sergiampietri C. Squamous cell carcinoma of the vagina: natural history, treatment modalities and prognostic factors. Crit Rev Oncol Hematol. 2015;93(3):211-24.
5.         Madsen BS, Jensen HL, van den Brule AJ, Wohlfahrt J, Frisch M. Risk factors for invasive squamous cell carcinoma of the vulva and vagina--population-based case-control study in Denmark. Int J Cancer. 2008;122(12):2827-34.
6.         Sadler L, Sykes P. How little is known about cervical cancer in pregnancy? Ann Oncol. 2005;16(3):341-3.
7.         Morice P, Uzan C, Gouy S, Verschraegen C, Haie-Meder C. Gynaecological cancers in pregnancy. Lancet. 2012;379(9815):558-69.
8.         Han SN, Gziri MM, Van Calsteren K, Amant F. Cervical cancer in pregnant women: treat, wait or interrupt? Assessment of current clinical guidelines, innovations and controversies. Ther Adv Med Oncol. 2013;5(4):211-9.
9.         Eitan R, Abu-Rustum NR. Management of cervical carcinoma diagnosed during pregnancy. Primary Care Update for OB/GYNS. 2003;10(4):196-200.
10.       Ribeiro F, Correia L, Paula T, Santana I, Pinto LV, Borrego J, et al. Cervical cancer in pregnancy: 3 cases, 3 different approaches. J Low Genit Tract Dis. 2013;17(1):66-70.
11.       Ungár L, Smith JR, Pálfalvi L, Del Priore G. Abdominal radical trachelectomy during pregnancy to preserve pregnancy and fertility. Obstet Gynecol. 2006;108(3 Pt 2):811-4.
12.       Van DeNIEUWENHOF H, VanHAM M, Lotgering F, Massuger L. First case of vaginal radical trachelectomy in a pregnant patient. Int J Gynecol Cancer. 200c;18(6):1381-5.
13.       de Haan J, Vandecaveye V, Han S, Van de Vijver K, Amant F. Difficulties with diagnosis of malignancies in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016;33:19-32.
14.       Robova H, Rob L, Pluta M, Kacirek J, Halaska Jr M, Strnad P, et al. Squamous intraepithelial lesion-microinvasive carcinoma of the cervix during pregnancy. Eur J Gynaecol Oncol. 2005;26(6):611-4.
15.       Fruscio R, Villa A, Chiari S, Vergani P, Ceppi L, Dell'Orto F, et al. Delivery delay with neoadjuvant chemotherapy for cervical cancer patients during pregnancy: a series of nine cases and literature review. Gynecol Oncol. 2012;126(2):192-7.
16.       Rabaiotti E, Sigismondi C, Montoli S, Mangili G, Candiani M, Viganò R. Management of locally advanced cervical cancer in pregnancy: a case report. Tumori. 2010;96(4):623-6.