A Stage 1B1 Clear Cell Cervical Cancer Patient who fell Pregnant whilst Awaiting Fertility Sparring Surgery Managed with Neoadjuvant Chemotherapy to Arrest Disease Progression
We present a case of a 25 years old woman who presented to the gynaecological oncology unit before pregnancy with a histological and clinical diagnosis of cervical squamous cell carcinoma stage 1B1. She desired fertility and hence an elective admission for vaginal trachelectomy (for fertility sparring) was planned. She fell pregnant whilst awaiting surgery and opted to continue with the pregnancy after counselling. She received neoadjuvant chemotherapy and was delivered at 36 weeks and a caesarean radical hysterectomy and pelvic lymphadenectomy was done. There is no disease recurrence after 2 years of follow up. This case highlights the challenges of prolonged waiting periods for surgery in our setting as well as the presentation of a rare histopathology of clear cell carcinoma. Clear cell adenocarcinoma of the cervix is associated with exposure to diethylstilboestrol (DES) in utero.
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