Recurrence of carcinoma cervix in the scar of previous cesarean section: a case report

Abstract

Although rare, reports of carcinoma cervix recurring in abdominal incision, episiotomy scars, laparoscopic port sites, and drain sites are available. However, recurrence in the scar of a previous cesarean section (CS) is unreported. A 49-year-old female with a diagnosis of keratinizing squamous cell carcinoma (SCC) of cervix, stage IIB, was treated by radical radiotherapy. She had undergone CS, through midline abdominal incision, for three previous deliveries. Twenty months later, she presented with a nodule of size 2.5 x 2 cm(2) on the 26-year-old abdominal CS scar. Infiltration of the skin and extension into the deeper structures of the abdominal wall was present in an area of 5 x 4 cm(2). There was no evidence of disease on the cervix. A fine-needle aspiration cytologic examination from the nodule revealed keratinizing SCC. Ultrasonography and computerized tomography scan revealed a mass lesion along the abdominal CS scar with subcutaneous nodule and peritoneal extension. Multiple metastatic lesions were present in the liver. She was treated with chemotherapy and radiotherapy. The patient has lived for more than 12.5 months. The first report of recurrence of carcinoma cervix in a CS scar is presented. Literature on surgical scar recurrence in carcinoma cervix is reviewed.

A Rare Case of Squamous Cell Carcinoma of the Cervix With Incisional Site Recurrence

“…Because of the rarity of incisional cancer recurrence, the optimal management of this condition is still unclear. Treatment is individualized and depends on the extent of the disease and the presence of metastasis [2,5]. The patient in the present report had the first recurrence at the incisional site, which was successfully treated with wide local excision without chemotherapy.…”

“…Patients commonly present with vaginal bleeding, back pain, leg edema, hematuria, weight loss, and abdominal lumps. Forty-one percent of recurrences occur within 1 year [2,5]. This case presented with an abdominal lump and recurrence in the superficial fascia at the lateral margin of the rectus abdominis muscle within 2 years after treatment.…”

Skin metastasis from squamous cell carcinoma of the cervix to the lower extremities: Case report and review of the literature

“…[1315] Other clinical presentations are maculopapular lesions, scar infiltration, and neoplastic alopecia. [16171819] Multiple lesions are less commonly seen than a solitary lesion. Lesions in most cases are asymptomatic, but pruritic or painful rash might precede the appearance of skin metastasis.…”

Abdominal Incision Metastasis from Carcinoma Cervix After Wertheim’s Hysterectomy

“…Chemo-radiation was advised to improve the quality of life of the patient. A survey of the literature showed few reported cases till date [5,6,7].…”