Case report: term birth after fertility-sparing treatments for stage IB1 small cell neuroendocrine carcinoma of the cervix

Abstract

BackgroundAdvances 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.Case presentationA 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.ConclusionTo 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.

Abdominal cerclage in a patient with a neocervix with planned cesarean hysterectomy at delivery

“…This data is consistent with other improved outcomes after removal of uterine septum resection 6 . Most data regarding pregnancy outcomes with a neocervix or no cervix after trachelectomy come from fertility sparing procedures for early stage cervical cancer or case reports 7,8 . Of 436 reported cases of pregnancy after fertility sparing surgery nearly 67% resulted in live birth, 26% were preterm and 10% had a second trimester spontaneous abortion – twice as high as the general population 9 .…”

[Retracted] Influence of Oxytocin Usage and Dose Difference During Delivery on Pregnancy Outcome of VBAC Pregnant Women

“…Montoya-Williams et al believed that some VBAC parturients have a prolonged labor process due to insufficient uterine contraction intensity, while the use of oxytocin can effectively enhance uterine contraction and productivity, and speed up the process of vaginal delivery. Some scholars have confirmed that the use of high-dose oxytocin is related to the risk of uterine rupture [ 7 ]. Although it is obvious that pregnant women can inject oxytocin intravenously during VBAC delivery, ACOG does not show the dose limit of oxytocin during uterine rupture and vaginal trial delivery [ 8 ].…”

Small Cell Neuroendocrine Carcinoma of the Cervix in Pregnancy: A Case Report and Review

“…Nine patients were dead of disease within 4 years of diagnosis. The longest survivor was for 84 months [4]. The poorest outcome was of woman who died one month after diagnosis as stage IV-B [17].…”