Carocha Ana Isabel, Pedroso Célia, Correia Lúcia, Gomes António, Jorge Ana Francisca
1Maternidade Dr. Alfredo da Costa, Centro Hospitalar de Lisboa and 2The Francisco Gentil Portuguese Institute of Oncology, Lisboa, Portugal.
J Low Genit Tract Dis. 2015 Apr;19(2):e31-4. doi: 10.1097/LGT.0000000000000054.
The authors describe the 20th known case of cervical cancer with metastasis in an episiotomy scar, being the first case describing an implant of malignant cells in the episiotomy scar associated with glassy cell carcinoma.
One case report.
We describe the case of a 34-year-old woman, with cervical cancer diagnosed 1 month after delivery. Four months later, a radical hysterectomy was performed. During surgery, a nodule at the site of the episiotomy scar was identified and removed. The histologic diagnosis revealed a glassy cell carcinoma of the cervix, with metastasis in the episiotomy scar. After surgery, chemotherapy and radiotherapy were performed. The disease progressed rapidly, and the patient died 9 months after surgery.
The implantation of neoplastic cells in the perineum is a potential risk of vaginal delivery, with a 40% mortality rate. It thus seems advisable to avoid vaginal delivery as much as possible when cervical cancer is diagnosed during pregnancy. Given the rarity, there are no studies on the most effective treatment in such situations.
作者描述了第20例已知的宫颈癌伴会阴切开术瘢痕转移病例，这是首例描述恶性细胞植入与玻璃样细胞癌相关的会阴切开术瘢痕的病例。
一份病例报告。
我们描述了一名34岁女性的病例，其在分娩后1个月被诊断为宫颈癌。4个月后，进行了根治性子宫切除术。手术过程中，在会阴切开术瘢痕处发现并切除了一个结节。组织学诊断显示为宫颈玻璃样细胞癌，伴有会阴切开术瘢痕转移。术后进行了化疗和放疗。疾病进展迅速，患者在手术后9个月死亡。
肿瘤细胞植入会阴是阴道分娩的一个潜在风险，死亡率为40%。因此，当孕期诊断出宫颈癌时，似乎应尽可能避免阴道分娩。鉴于这种情况罕见，尚无关于此类情况下最有效治疗方法的研究。
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