1/94. Small cell carcinoma of the cervix complicated by pregnancy.We report the results of treatment in a 26-year old patient with stage IB2 small cell carcinoma of the cervix complicated by pregnancy. A pathological complete remission was achieved following sandwich chemotherapy and radiotherapy. The patient remains in clinical remission 14 months after presentation.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/94. First case of pregnancy after radical trachelectomy and pelvic irradiation.BACKGROUND: Invasive carcinoma of the cervix above stage IA1 is usually treated by radical hysterectomy and/or radiotherapy, leading to definitive sterility. CASE REPORT: We report the case of a young patient with stage IB1 carcinoma of the cervix treated in June 1995 by radical trachelectomy (according to the technique described by Dargent) and adjuvant brachy teletherapy. A hormonal replacement of "menopause" was prescribed. One year later, she became pregnant and at 27 weeks gestation gave birth to a healthy child by cesarean section. CONCLUSION: Radical trachelectomy is one of the most recent therapeutic steps forward in the treatment of early stage invasive cervical carcinoma, which can surely be treated in some cases preserving child-bearing potential.- - - - - - - - - - ranking = 0.86146937629163keywords = pregnancy, gestation (Clic here for more details about this article) |
3/94. Primary malignant lymphoma of the cervix in pregnancy. A case report.BACKGROUND: Malignant lymphoma arising from the uterine cervix is a very rare entity. Only two such patients have been reported as pregnant at the time of diagnosis. CASE: A 35-year-old woman (negative Pap smear at antenatal clinics) was referred because of the accidental finding of a huge cervical mass during labor. The patient underwent cesarean section because of arrest of cervical dilatation and persistent floating of the fetal head. The final diagnosis of this cervical mass was malignant lymphoma, low grade B cell, after radical abdominal hysterectomy. CONCLUSION: Although labor obstructed by a tumor of the pelvic organs is a relatively rare event and the majority of cases are benign leiomyomas of the uterus or cervix, the risk of pelvic malignancies should be considered. Bimanual examination and pelvic ultrasound and/or color Doppler ultrasound should be applied without hesitancy in any uncertain situation during pregnancy or labor.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
4/94. A staff dialogue on a socially distanced patient: psychosocial issues faced by patients, their families, and caregivers.Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. The following case of an hiv-positive woman who was diagnosed with cervical cancer during a twin pregnancy was discussed at the May, 1999 Schwartz Center Rounds. The patient was in drug rehabilitation having been dependent on crack cocaine, with a past history of syphilis and gonorrhea. She was single and her other children were in foster care. Initially she was suspicious and non-compliant. A plan was negotiated to biopsy the cervical lesion after cesarean section and with confirmation of malignancy she underwent radical surgery and subsequently radiotherapy. Despite the almost insurmountable social and educational distance between her and her caregivers, they managed to bond and facilitate care. Although there were compromises with which staff were uncomfortable, the relationship was maintained and continues.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
5/94. Unusual recurrence of cervical adenosquamous carcinoma after conservative surgery.The use of less radical procedures for the treatment of early cervical cancers is gaining interest among physicians and young patients. Some authors have described surgical procedures aimed at reducing the surgical aggressiveness but the safety of such procedures remains debated. After a polypectomy, a young patient had a diagnosis of stage Ia(2) cervical adenosquamous carcinoma in 1995. As she wished to preserve her fertility, she underwent a cone biopsy and pelvic lymphadenectomy, without evidence of tumor spread. In 1998, at the 13th week of gestation, she had a diagnosis of a pelvic mass. The mass was a recurrence of carcinoma involving the myometrium, just underneath the peritoneum. She underwent a radical hysterectomy with bilateral oophorectomy. An ovarian metastasis was also detected at pathological exam. She received chemotherapy postoperatively and remains alive without evidence of disease. The recurrence of cervical cancer is traditionally regarded as an issue concerning the cervix, the parametria, or the lymph nodes. When the uterus is preserved we must also consider the possibility of a recurrence involving the corpus. With wider acceptance of limited therapeutic approaches we must be prepared for the detection of previously unknown patterns of recurrence and the follow-up modalities must be consequently adapted.- - - - - - - - - - ranking = 0.061469376291628keywords = gestation (Clic here for more details about this article) |
6/94. Successful preservation of fertility subsequent to a complete pathologic response of a squamous cell carcinoma of the uterine cervix treated with primary systemic chemotherapy.This is the first report about a successful pregnancy following treatment for advanced cervical cancer.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
7/94. Chemotherapy in the treatment of locally advanced cervical cancer and pregnancy.BACKGROUND: Carcinoma of the cervix is the most common malignant tumor associated with pregnancy. The initial stages and premalignant lesions apparently present the same prognosis in pregnant and nonpregnant women; however, there are limited data regarding outcome for locally advanced cervical cancer in pregnancy. CASE: A 26-year-old woman, gravida 4, para 3, at 14 weeks and 4 days' gestation, was diagnosed with a FIGO stage IIB squamous cell carcinoma of the cervix, treated by primary chemotherapy with cisplatin and bleomycin, until pregnancy resolution at 38 weeks. The newborn infant is currently 3 years old and presents no evidence of abnormalities in neuropsychomotor development. CONCLUSION: The present case demonstrates that chemotherapy was harmless for the child up to the present time. However, a longer follow-up is needed to determine the safe outcome of this child.- - - - - - - - - - ranking = 1.4614693762916keywords = pregnancy, gestation (Clic here for more details about this article) |
8/94. Neuroendocrine small cell carcinoma of the uterine cervix showing polypoid growth and complicated by pregnancy.BACKGROUND: Neuroendocrine small cell carcinoma of the uterine cervix is an aggressive disease, and it rarely is complicated by pregnancy. CASE: A polypoid tumor was found in the uterine cervix in a 27-year-old Japanese woman at 27 weeks of gestation. No polyp had been detected at 14 weeks of gestation. The polyp was excised and diagnosed as neuroendocrine small cell carcinoma by histological examination, including Grimelius, neuron-specific enolase, and chromogranin staining. A healthy infant was born by cesarean section at 29 weeks of gestation: this was followed by radical hysterectomy with pelvic lymphadenectomy. After surgery, four cycles of combination chemotherapy with cisplatin and etoposide were administered, and the patient is disease-free as of 13 months after surgery. CONCLUSION: When a polypoid lesion is found, especially when it demonstrates rapid growth, it may be necessary to excise and histologically examine the polyp even during pregnancy.- - - - - - - - - - ranking = 1.3844081288749keywords = pregnancy, gestation (Clic here for more details about this article) |
9/94. Term delivery following conservative treatment for villoglandular papillary adenocarcinoma of the uterine cervix: report of a case and analysis of the literature.BACKGROUND: Villoglandularpapillary adenocarcinoma (VPA) of the cervix is often indolent, and surgical treatment has a favorable outlook. risk factors include depth of invasion, lymphovascular invasion, and the presence of other histologic types of cancer. CASE: An amputation of the cervical portio was required to satisfactorily resect a 2.5-cm ectocervical lesion in a 28-year-old nulligravida. A diagnosis of pure VPA with a depth of invasion less than 2 mm was established. During a subsequent pregnancy, second trimester ultrasound showed extreme effacement of her cervix and an abdominal cerclage was placed. The pregnancy continued until delivery of a healthy infant at 36 weeks. CONCLUSIONS: In cases of tumor invasion less than 3 mm, and in the absence of lymphovascular space involvement, extrauterine spread of pure VPA has not been described. When conservative treatment is planned, amputation of the cervical portio may be better suited than conization to the achievement of an adequate margin of resection. Cervical cerclage may be needed to offset the extensive cervical surgery.- - - - - - - - - - ranking = 0.4keywords = pregnancy (Clic here for more details about this article) |
10/94. Laparoscopic lymph node staging of cervical cancer in the 19th week of pregnancy. A case report.We present the case of a 39-year-old gravida I para 0 woman who underwent laparoscopic staging of lymph node involvement in cervical cancer in the 19th week of pregnancy. She had been diagnosed with adenosquamous carcinoma of the cervix, stage 1B1, grade 2, with tumor involvement of the lymphovascular space and tumor involved resection margins via a cone biopsy in the 16th week of pregnancy. In order to decide whether it would be safe to proceed with the pregnancy, she was submitted to the laparoscopic exposure and removal of 18 parametric and pelvic lymph nodes. One positive lymph node was detected at the right internal iliac artery; therefore, an open radical hysterectomy with paraaortic lymphadenectomy was performed. This case shows that lymph node staging for cervical cancer can be done laparoscopically in the 2nd trimester. Information yielded during the course of this procedure can be crucial in deciding whether it is possible to preserve the pregnancy.- - - - - - - - - - ranking = 1.6keywords = pregnancy (Clic here for more details about this article) |
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