Challenges in Diagnosis and Treatment of a Cervical Carcinoma Complicated by Genital Prolapse

Abstract

Cervical squamous cell carcinoma of the uterus associated with pelvic organ prolapse is very rare and usually occurs in elderly women. We hereby present an 81-year-old postmenopausal woman presented to the outpatient department with an ulcerated irreducible uterine procidentia. The prolapse was reduced under general anesthesia and biopsy of the lesions confirmed a cervical squamous cell carcinoma. Pretreatment clinical staging revealed a 16 cm enlarged uterus and mild to moderate unilateral hydroureteronephrosis, secondary to periureteric infiltration, clinical stage IIIB. The patient was disqualified from surgery, and palliative chemotherapy plus radiotherapy was recommended. Patient’s general condition was rapidly deteriorated, and three months after the diagnosis, the patient passed away. Therapeutic management of cervical cancer associated with uterovaginal prolapse is not well established. Hence, this article presents the clinical concerns that arise in such rare and neglected cases.

Synchronous occurrence of HPV-associated cervical squamous cell carcinoma (FIGO IIA) in prolapsed uterus and adenocarcinoma of the anal canal cT1N0M0

“…One of them suggests the second cancer to be treated in the shortest possible time. [11] In the case presented herein, the choice of the cancer that was treated first was conditioned by the presence of bothersome symptoms, that is, bleeding.…”

“…However, some general guidelines concerning the treatment of synchronous neoplasms are available in the literature. One of them suggests the second cancer to be treated in the shortest possible time [11] . In the case presented herein, the choice of the cancer that was treated first was conditioned by the presence of bothersome symptoms, that is, bleeding.…”

“…It is estimated that 1% of CC patients develop uterine prolapse [6] . On the other hand, the incidence of CC among patients with uterine prolapse is 0.14% to 1% [10–12] …”

“…[6] On the other hand, the incidence of CC among patients with uterine prolapse is 0.14% to 1%. [10][11][12] The incidence of ACC is very low reaching 1.5:100,000 but rising, due to spreading of HPV and HIV, autoimmune disorders and cigarette smoking. [13] Synchronous neoplasms may have a common etiological factors, HPV infection being a well recognized one.…”

Treatment of Cervical Cancer Complicated by Advanced Pelvic Organ Prolapse: A Case Report

“…Treatment planning in these scenarios is complicated by distorted anatomy, altered target mobility, and externalization of lesions. Although there are currently no well-established treatment recommendations, the available literature highlights the importance of multidisciplinary care and coordination 4–6 …”