Kurniadi Andi, Setiawan Dani, Kireina Jessica, Suardi Dodi, Salima Siti, Erfiandi Febia, Andarini Mia Yasmina
Department of Obstetrics and Gynecology, Universitas Padjadjaran, Bandung, Indonesia.
Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia.
Int J Womens Health. 2023 Jul 27;15:1213-1218. doi: 10.2147/IJWH.S420801. eCollection 2023.
Cervical cancer in pregnancy is rare and its management remains a formidable challenge. Clinical upstaging is a serious concern. Presentation may mimic pregnancy-related conditions, thus delaying diagnosis and leading to an advanced stage at presentation. In addition, concerns regarding chemotherapy safety in pregnancy may hinder its administration. Definitive therapy may also be delayed due to pregnancy.
A 37-year-old G3P2A0 10-11 weeks pregnant woman was diagnosed with stage IB2 cervical cancer. We originally planned to perform neoadjuvant chemotherapy with paclitaxel 175mg/m and carboplatin 6 AUC every 21 days followed by caesarean section and radical hysterectomy. However, preoperatively, the tumor had grown further and progressed to stage IIB. Postpartum radiotherapy was thus indicated. Lower segmental caesarean section along with bilateral salpingectomy and ovarian transposition were performed. Radiotherapy was administered through external beam radiation therapy and brachytherapy. The patient delivered a small for gestational age male baby with no abnormalities. At 2-month follow-up, the infant appeared generally healthy.
Cancer diagnosis during pregnancy adversely impacts women's physical and psychological states. Symptoms may mimic pregnancy-related conditions, thus delaying diagnosis. Its management involves a multidisciplinary team to protect both maternal and fetal health.
妊娠期宫颈癌较为罕见，其治疗仍然是一项艰巨的挑战。临床分期是一个严重问题。临床表现可能类似于与妊娠相关的情况，从而延迟诊断并导致就诊时处于晚期。此外，对妊娠期化疗安全性的担忧可能会阻碍化疗的实施。由于妊娠，确定性治疗也可能延迟。
一名37岁、孕3产2、流产0次、妊娠10 - 11周的孕妇被诊断为IB2期宫颈癌。我们最初计划每21天用175mg/m的紫杉醇和6AUC的卡铂进行新辅助化疗，随后行剖宫产和根治性子宫切除术。然而，术前肿瘤进一步生长并进展至IIB期。因此，指示进行产后放疗。进行了下段剖宫产术，同时行双侧输卵管切除术和卵巢移位术。通过外照射放疗和近距离放疗进行放疗。患者分娩出一名小于孕周的男婴，无异常。在2个月的随访中，婴儿总体健康。
妊娠期癌症诊断对女性的身体和心理状态产生不利影响。症状可能类似于与妊娠相关的情况，从而延迟诊断。其治疗需要多学科团队参与，以保护母婴健康。
