Multidisciplinary approach in the pelvic relapse of a previously irradiated cervical tumor

This educational video shows a step by step approach for anterior infra levator exenteration with colpectomy along with intraoperative radiation for recurrent/persistent cervical cancer in a patient with one kidney. The patient underwent urinary diversion and neovaginal reconstruction.

A 31-year-old woman with a past medical history of systemic lupus erythematosus and congenital absence of the left kidney was diagnosed with a 4 cm IIA squamous cervical carcinoma in the context of immunosuppressive therapy. Beyond the proximal vaginal involvement, the workup failed to show any extracervical disease.

Standard concomitant chemoradiotherapy resulted in a questionable partial response. Four months after chemoradiation, pelvic magnetic resonance imaging showed a 4.5 cm persistent cervical mass along with mild right hydronephrosis and vaginal involvement. Positron emission tomography-computed tomography (PET-CT) confirmed the metabolic activity of the cervical tumor without demonstrating distant metastases.

CITA DE ARTÍCULO  Int J Gynecol Cancer. 2020 May;30(5):714.
doi: 10.1136/ijgc-2020-001207. Epub 2020 Mar 2