Carcinoma of the cervix complicating a genital prolapse

Pardal, Catarina; Correia, Catia; Serrano, Paula

doi:10.1136/bcr-2015-209580

Cited by 13 publications

(18 citation statements)

References 3 publications

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“…However, radical surgery seems to be the option of choice in order to prevent the development of serious adverse events (3,22,24,25). Therefore, whenever possible, surgery should be preferred instead of radiation therapy due to the risk of visceral injury by ionizing radiation administration (26).…”

Section: Discussionmentioning

confidence: 99%

Radical Hysterectomy for Cervical Cancer in Patients With Uterine Prolapse

Bacalbaşa

Hălmaciu

Crețoiu

et al. 2020

In Vivo

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Background/Aim: Association between cervical cancer and uterine prolapse represents a scarce eventuality. This is a case series of 11 patients diagnosed with different stages of cervical cancer in association with uterine prolapse. Patients and Methods: Between 2014 and 2020, 11 patients were diagnosed with cervical cancer on prolapsed uterine cervix. Results: The mean age of patients at the time of uterine cervix diagnosis was 68 years. In six cases, the first intent treatment was surgery, while in the remaining five cases it consisted of radio-chemotherapy, followed by radical surgery. The perioperative and postoperative outcomes were compared to those reported in a similar series of patients diagnosed in similar stages of the disease, but in the absence of uterine prolapse, no significant differences being encountered. Conclusion: Although it represents an unusual situation, malignant transformation of the uterine cervix might be encountered even in cases presenting uterine prolapse. In such cases, the therapeutic strategy should be tailored according to the stage of the disease. Chronic inflammation is widely accepted to be associated with the development of certain malignancies such as skin, liver or lung cancer (1). When it comes to cervical cancer patients, the relationship between chronic inflammation, malignant transformation, viral infection and uterine prolapse is a controversial one. Women presenting a complete uterine prolapse are predisposed to a long process of chronic inflammation and direct mechanical irritation of the prolapsed areas, increasing in this way the risks of cervical cancer development; therefore, in such cases, special attention should be given to this aspect, and the patients should be routinely submitted to more specific investigations, such as colposcopy, endocervical and exocervical examination, in order to achieve an early diagnosis of the neoplastic disease whenever it develops (1). Furthermore, virology studies have underlined the fact that the displacement of the uterine cervix in cases in which 2073 This article is freely accessible online.

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Section: Discussionmentioning

confidence: 99%

Radical Hysterectomy for Cervical Cancer in Patients With Uterine Prolapse

Bacalbaşa

Hălmaciu

Crețoiu

et al. 2020

In Vivo

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“…In a retrospective review, Grigoriadis reported that the incidence of cervical cancer in women undergoing a vaginal hysterectomy for pelvic organ prolapse was 0.3% ( Grigoriadis et al, 2015 ). The treatment of these two coexisting conditions is rare but has been summarized in reports by Pardal et al, Cabrera et al and Matsuo et al ( Pardal et al, 2015 ; Cabrera et al, 2010 ; Matsuo et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

“…The treatment strategies for invasive cervical carcinoma are often dictated by clinical stage of the disease, presence or absence of metastatic disease and patient's performance status. Treatment options that have been employed in patients with pelvic organ prolapse complicated by cervical cancer include radio-chemotherapy with obliterative vaginal surgery ( Reimer et al, 2008 ), vaginal hysterectomy with pelvic node dissection followed by radiation therapy ( Pardal et al, 2015 ) and laparoscopic radical hysterectomy ( Cabrera et al, 2010 ). Since the index patient demonstrated both a significant cystocele and enterocele along with a wide genital hiatus, it was necessary to reduce her pelvic organ prolapse before external beam radiation therapy could be initiated.…”

Section: Discussionmentioning

confidence: 99%

Cervical cancer complicating pelvic organ prolapse, and use of a pessary to restore anatomy for optimal radiation: A case report

Dawkins

Lewis

Toy

2018

Gynecologic Oncology Reports

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Cervical cancer is the most common gynecologic malignancy worldwide and the third most common gynecologic cancer in the USA. Improved screening methods such as liquid-based cytology accompanied by Human Papilloma Virus (HPV) co-testing have contributed to a declining incidence of cervical cancer. There are approximately 13,000 new cases per year in the United States, accounting for 4200 deaths (Siegel et al., 2011). Pelvic organ prolapse increases with age, obesity and parity. In the absence of bothersome urinary, gastrointestinal or pressure symptoms, patients may choose conservative management options.The index patient was a 72 year old woman with a known history of pelvic organ prolapse who had been managed by her primary physician for 7 years until she developed new-onset vaginal bleeding. One month following worsening prolapse and increased vaginal bleeding she presented to the emergency department and was evaluated. On physical examination the cervix appeared as an 8 cm exophytic fungating mass extruding from the vagina and bled easily from areas of apparent necrosis. Multiple biopsies confirmed an invasive squamous cell carcinoma. The patient underwent the insertion of a Gelhorn pessary and perineorrhaphy to reduce her procidentia, cystocele and enterocele. Chemotherapy with Cisplatin and radiation therapy in the form of brachytherapy and external beam radiation therapy were then administered with curative intent.Cervical cancer complicating a uterine procidentia in an elderly patient is a rare occurrence in the United States and requires a multidisciplinary approach involving a urogynecologist, a gynecologic oncologist and a radiation oncologist. Nonetheless, in carefully selected patients, the outcome can be successful.

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“…First, survival outcomes have been more favorable with surgery‐based treatment than with radiation‐based therapy for stages I to IV cervical cancer (5‐year recurrence‐free survival rate: 72.0% vs. 62.9%; 5‐year disease‐specific overall survival rate: 77.0% vs. 68.2%) 1 . Second, tumor regression and organ motion can affect the radiation dose, 12 and cystocele‐rectocele may increase the risk of visceral radiation injury 13 that lowers QOL.…”

Section: Discussion/conclusionmentioning

confidence: 99%