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Re: Interesting case of cervical cancer in pregnancy From: A.C. Evans (ahcevans@execpc.com) Thu Apr 27 09:44:19 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: tconnolly,d.o.: "Re: Gyn: Gail Model 1.9" Previous message: sanbonav@tin.it: "O-RING-TEST AND ORAL CONTRACEPTIVES" In reply to: Dr Sarita Bhalerao: "Interesting case of cervical cancer in pregnancy" Next in thread: Dr. Myer Bornstein: "Re: Interesting case of cervical cancer in pregnancy" On Wed, 26 Apr 2000 10:13:35 -0500, saritabhalerao@hotmail.com (Dr Sarita Bhalerao) wrote: >A 28 year old lady, para 2 is presently 29 weeks pregnant. She reported >with per vaginal bleeding. On examination she was found to have a >polypoid growth arising from the cervix. >Biopsy of the growth reveals a high grade adenocarcinoma. Clinical >examination reveals induration in the left parametrium,right parametrium >is free.Parametrial involvement is thus doubtful. >I would like to ask the forum how best to manage this case. Induration in the parametrium is very suspicious in most cases. Would be very hesitant to say there is no invasion if there is induration there. If available and radiologists are willing....I would recommend MRI to assess the parametria and to define the extent of the lesion. How big is the lesion? How small or large is the patient? Any other medical issues with her? This patient may not be a good candidate for Cesarean radical hysterectomy. Reasons not to do it: Minimal invasion Large lesion (more than 4 cm) Parametrial spread Poor surgical candidate/obesity Limited availability of blood products (would not use cell saver) Note that cervical cancer is not surgically staged. If patients have surgery, surgical information is utilized in planning therapy, but this cancer continues to be staged clinically. If the lesion is not growing alarmingly fast, would wait until fetal lung maturity before delivering (there is no contraindication to use of steroids in these cases). If going to have radiation, can deliver vaginally unless there is a risk of hemorrhage from a large tumor. If risk of hemorrhage is high or if rad hyst is planned, Cesarean delivery would be appropriate. If the lesion is very small, conization should be done prior to assess depth of invasion...rad hyst may be unnecessary. Hope this is helpful, Craig Evans, MD, PhD Director, Gynecologic Oncology Vince Lombardi Cancer Clinics Milwaukee, WI Next message: tconnolly,d.o.: "Re: Gyn: Gail Model 1.9" Previous message: sanbonav@tin.it: "O-RING-TEST AND ORAL CONTRACEPTIVES" In reply to: Dr Sarita Bhalerao: "Interesting case of cervical cancer in pregnancy" Next in thread: Dr. Myer Bornstein: "Re: Interesting case of cervical cancer in pregnancy"

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