Moreno-Luna Estefania, Alonso Patricia, Santiago Javier De, Zapardiel Ignacio
Gynaecological Oncology Unit, La Paz University Hospital, Madrid 28046, Spain.
Ecancermedicalscience. 2016 Sep 6;10:673. doi: 10.3332/ecancer.2016.673. eCollection 2016.
Invasive cervical cancer is rare during a pregnancy, even though it is one of the most frequently diagnosed neoplasias during that time. It is noted that around 30% of women diagnosed with cervical cancer are of reproductive age. This means that up to 3% of cases of cervical cancer are found in pregnant women or those who are in the post-birth period. A cervicovaginal Pap smear is performed as part of the regular checkup for a pregnant woman during the first visit so that cervical cancer can easily be diagnosed early in these women, detecting it early in up to 70-80% of cases. We present here the case of a patient with initial diagnosis of cervical cancer made around 20th week of pregnancy. It was then treated by a simple trachelectomy and cerclage during week 24. The pregnant woman gave birth to a healthy baby at the end of her pregnancy. Definitive treatment was completed three months after giving birth with a total hysterectomy and laparoscopic bilateral salpingectomy while preserving both ovaries. After 17 months of monitoring the patient showed no signs of reoccurrence. In conclusion, during the early stage of cervical cancer conservative management may be a reasonable option to preserve the current pregnancy.
浸润性宫颈癌在孕期较为罕见,尽管它是孕期最常被诊断出的肿瘤之一。值得注意的是,约30%被诊断为宫颈癌的女性处于生育年龄。这意味着高达3%的宫颈癌病例是在孕妇或产后女性中发现的。宫颈阴道巴氏涂片检查是孕妇首次就诊时常规检查的一部分,这样宫颈癌在这些女性中就能很容易地被早期诊断出来,在高达70 - 80%的病例中能早期检测到。我们在此呈现一例在妊娠约20周时初步诊断为宫颈癌的患者病例。然后在第24周时通过简单的宫颈切除术和宫颈环扎术进行了治疗。该孕妇在妊娠末期生下了一个健康的婴儿。产后三个月完成了根治性治疗,进行了全子宫切除术和腹腔镜双侧输卵管切除术,同时保留了双侧卵巢。经过17个月的监测,患者未显示复发迹象。总之,在宫颈癌早期,保守治疗可能是保留当前妊娠的合理选择。