J Gynecol Oncol | Volume 4, Issue 1 | Case Report | Open Access

Caesarean Hysterectomy for Cervical Cancer Complicating Pregnancy: Life-Saving Procedure or Hazardous Choice?

Castellani C¹, Di Loreto E¹, Perugino G¹, Orsi M¹, Preti EP², Ramezzana IG¹, Polverino G¹, Cribiù FM³, Ossola MW¹ and Scarfone G^1*

¹Department of Gynecology and Obstetrics, IRCCS Ca 'Granda Foundation, Maggiore Policlinico Hospital, Italy
²Department of Gynecology, European Institute of Oncology, Italy
³Department of Pathology, IRCCS Ca 'Granda Foundation, Maggiore Policlinico Hospital, Italy

^*Correspondance to: Scarfone Giovanna 

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Abstract

Cervical cancer is the most common pregnancy-associated gynecological cancer. Owing to the absence of randomized trials the management remains subject of debate, and it must consider also the gestational age at diagnosis, the patient’s wish to continue the pregnancy and to preserve future fertility. Here, we report a 43‐year‐old primipara who was referred to our institution at 34 weeks of gestation with a diagnosis of moderately differentiated adenocarcinoma of the uterine cervix stage IB1. At 36 weeks of gestation, caesarean hysterectomy was performed, and a female healthy baby weighing 3185 gm was born. Uterine atony refractory to medical treatment and uterine arteries ligation was observed just after delivery. Bowel adhesions related to previous myomectomy, prolonged the surgery. The massive bleeding led to the decision to perform simple instead of radical hysterectomy, followed by systematic pelvic lymphadenectomy. Three units of packed red blood cells and three of fresh frozen plasma were transfused. Pathological examination conducted to re-staging to stage IA1. After 8 months of follow-up, the mother and the baby are healthy. These findings suggest that caesarean hysterectomy for cervical cancer complicating pregnancy is a feasible option. Emphasis should be posed to preoperative counseling, enlightening the benefit and risk of the available conservative and demolitive treatment options.

Keywords:

Cervical cancer; Caesarean hysterectomy; Cancer in pregnancy; Uterine atony; Postpartum hemorrhage

Citation:

Castellani C, Di Loreto E, Perugino G, Orsi M, Preti EP, Ramezzana IG, et al. Caesarean Hysterectomy for Cervical Cancer Complicating Pregnancy: Life-Saving Procedure or Hazardous Choice?. J Gynecol Oncol. 2021; 4(1): 1049.