Curative treatment of a pelvic side wall recurrence after conization for microinvasive cervical cancer stage IA1: a case report and review of the literature

J Low Genit Tract Dis. 2007 Jul;11(3):177-81. doi: 10.1097/lgt.0b013e3180316720.

Abstract

Background: For patients wishing to preserve fertility conization is regarded as an adequate treatment in cervical cancer stage IA1 without lymphovascular space involvement (LVSI). Reviewing case series with IA1 cervical cancers without LVSI, lymph node metastasis (LNM) is present in 0.5%.

Materials and methods: We pr esent a case of a 34-year-old patient treated with conization for squamous cervical cancer invading 1.2 mm without LVSI and horizontal extension of 6 mm (IA1).

Results: At a routine postpartum examination after an uneventful pregnancy, a 5-cm pelvic mass was noted at the right pelvic wall. Intraoperative evaluation revealed a LNM which was resected, and postoperative pelvic chemoradiotherapy was performed. The patient remains recurrence-free 84 months after conization and 73 months after resection of the recurrence.

Conclusions: Occurrence of LNM in IA1 cervical cancers is very rare, but if early diagnosed curative treatment is possible.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / virology
  • Colposcopy
  • Conization*
  • Female
  • Human papillomavirus 18 / isolation & purification
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Neoplasm Invasiveness
  • Pelvic Neoplasms / pathology*
  • Pelvic Neoplasms / surgery
  • Pelvic Neoplasms / virology
  • Radiotherapy Dosage
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / virology