Rapidly progressive squamous cell carcinoma of the cervix in a patient with acquired immunodeficiency syndrome: case report.

Recent evidence suggests an association between cervical condyloma, dysplasia and HIV infection. However, the course of cervical cancer in immunodeficient patients has not yet been thoroughly researched. Cervical cancer presently amounts to 1% of the causes of death in AIDS patients. This percentage is bound to increase not only because an improved life expectancy has been obtained, but mainly because the virus is widely spreading among the female population. A 28 year-old AIDS patient, parity 1/0/1/1, underwent gynecological examination and colposcopy following an episode of vaginal bleeding. Biopsy revealed an invasive cervical carcinoma. The last gynecologic investigation, which included a Pap smear and colposcopy, was performed 14 months earlier and resulted negative. Cytologic reexamination of the specimen confirmed the previous Pap smear result. Proctoscopy and cystoscopy showed no mucose involvement. Urography was negative. The cat scan indicated minor spleen and liver enlargement but no signs of malignant abdominal spread were found. The neoplasia was classified as a stage IIB cervical carcinoma (according to the FIGO classification) due to the spread to the left cardinal ligament. In spite of radiation therapy, the disease rapidly progressed leading to a monolateral ureteral involvement which created a juxtavescical stenosis. The patient died three months later. Necroscopic examination revealed lung metastasis. Such a rapidly progressive form of cervical cancer could be related to the acquired immunodeficiency condition. Recurrent cytological and colposcopic examinations are to be considered mandatory in HIV patients.