Wu Pei-Ying, Cheng Ya-Min, New Geok Huey, Chou Cheng-Yang, Chiang Chun-Ting, Tsai Hung-Wen, Huang Yu-Fang
Department of Obstetrics & Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng-Li Rd. Northern District, Tainan, 70403, Taiwan.
Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng-Li Rd. Northern District, Tainan, 70403, Taiwan.
BMC Womens Health. 2017 Jul 28;17(1):56. doi: 10.1186/s12905-017-0404-0.
Advances in cervical cancer management for childbearing women have led to less radical approaches. Use of fertility-sparing treatment to treat small cell neuroendocrine carcinoma (SCNEC) is challenging owing to the aggressive nature of the disease, even in early stage disease.
A 25-year-old nulligravida woman presented with malodorous vaginal discharge and was diagnosed to have an exophytic cervical SCNEC. A magnetic resonance image scan showed no evidence of parametrial invasion or distant metastasis. Clinical staging allocated her to stage IB1 disease. She underwent radical abdominal trachelectomy for reproductive purpose. Preoperative and postoperative chemotherapy with ifosfamide/etoposide/cisplatin combining gonadotropin-releasing hormone agonist were administered. She had a spontaneous, uneventful pregnancy and successfully delivered a term baby via cesarean section 7 years after treatment.
To our knowledge, we describe the first success in offering a fertility-preserving multimodality strategy to present favorable oncologic, reproductive, and obstetric outcomes in a fertile woman of stage I SCNEC. Individualized multimodality therapy may be utilized in specific patients with early-stage cervical cancer to preserve their fertility.
育龄期女性宫颈癌治疗方法的进展使得治疗方式不那么激进。由于小细胞神经内分泌癌(SCNEC)具有侵袭性,即使在疾病早期,采用保留生育功能的治疗方法来治疗这种癌症也具有挑战性。
一名25岁未孕女性因阴道分泌物有异味就诊,被诊断为外生性宫颈SCNEC。磁共振成像扫描显示没有宫旁组织浸润或远处转移的证据。临床分期为IB1期疾病。为了保留生育功能,她接受了根治性腹式宫颈切除术。术前及术后采用异环磷酰胺/依托泊苷/顺铂联合促性腺激素释放激素激动剂进行化疗。治疗7年后,她自然受孕,孕期顺利,并通过剖宫产成功产下一名足月婴儿。
据我们所知,我们首次成功地为一名I期SCNEC的育龄女性提供了保留生育功能的多模式策略,取得了良好的肿瘤学、生殖和产科结局。个体化多模式治疗可用于特定的早期宫颈癌患者以保留其生育功能。