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%.
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).
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.
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: firstname.lastname@example.org