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Curative Treatment of a Pelvic Side Wall Recurrence After Conization for Microinvasive Cervical Cancer Stage IA1: A Case Report and Review of the Literature

Dedes, Konstantin J. MD1; Dedes, Miltiades MD2; Varga, Zsuzsanna MD3; Zimmermann, Dieter R. MD4; Fink, Daniel MD1; Fehr, Mathias K. MD1

Journal of Lower Genital Tract Disease: July 2007 - Volume 11 - Issue 3 - p 177-181
doi: 10.1097/lgt.0b013e3180316720
Case Reports
Spanish Translation

Background. For patients wishing to preserve fertility conization is regarded as an adequate treatment in cervical cancer stage IA1 without lymphovascular space involvement (LVSI). Reviewing case series with IA1 cervical cancers without LVSI, lymph node metastasis (LNM) is present in 0.5%.

Materials and Methods. We pr esent a case of a 34-year-old patient treated with conization for squamous cervical cancer invading 1.2 mm without LVSI and horizontal extension of 6 mm (IA1).

Results. At a routine postpartum examination after an uneventful pregnancy, a 5-cm pelvic mass was noted at the right pelvic wall. Intraoperative evaluation revealed a LNM which was resected, and postoperative pelvic chemoradiotherapy was performed. The patient remains recurrence-free 84 months after conization and 73 months after resection of the recurrence.

Conclusions. Occurrence of LNM in IA1 cervical cancers is very rare, but if early diagnosed curative treatment is possible.

The authors report a case of a patient with squamous cervical cancer stage IA1 without LVSI treated by conization who developed subsequent lymph node metastasis (LNM), and could be cured by surgery and chemo-radiotherapy.

1Division of Gynecology, Department of Obstetrics and Gynecology, University Hospital of Zurich, Zurich, Switzerland, 2Private practice, Glarus, Switzerland, 3Department of Pathology, Institute of Clinical Pathology, University Hospital of Zurich, Zurich, Switzerland, and 4Department of Pathology, Laboratory of Molecular Biology, University Hospital of Zurich, Zurich, Switzerland

Reprint requests to: Mathias K. Fehr, MD, Department of Obstetrics and Gynecology, Division of Gynecology, University Hospital of Zurich, 8091 Zurich, Switzerland. E-mail: mathias.fehr@usz.ch

©2007The American Society for Colposcopy and Cervical Pathology