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Abstract: A 49-year-old female patient came to our hospital for routine cervical cancer screening and was surprised when she was diagnosed with cervical cancer, knowing that she did not have any discomfort, how could she have cervical cancer? In fact, this is one of the reasons why people ignore cervical cancer. Fortunately, this patient’s physical examination detected the disease in time, and after radical hysterectomy and 4 weeks of treatment with paclitaxel injection and carboplatin for injection, her condition was stable and she recovered well.
Basic information】Female, 49 years old
Type of disease】Cervical cancer
Hospital】Hunan Provincial Maternal and Child Health Hospital
Date of consultation】June 2022
Treatment plan】Surgical treatment (laparoscopic radical hysterectomy)
Treatment period】4 weeks of hospitalization, review after 1 month, long-term follow-up
Treatment effect】Stable condition, good recovery
I. Initial consultation
The patient had not been screened for cervical cancer in the past and had no abnormal vaginal bleeding or fluid flow, and routine cervical cancer screening HPV test showed: type 18 (+). Our TCT showed a high degree of squamous intraepithelial lesion, colposcopy showed a cauliflower-like superfluous organism about 1 cm in the upper lip of the cervix with heterogeneous blood vessels, and cervical biopsy showed (6°) chronic inflammation of mucosal tissue, no mucus glands, a little mucus in the cervical canal with mucus gland epithelium, and (cervical superfluous organism) malignant epithelial tumor. The preliminary diagnosis was cervical cancer, and the patient was admitted to our department. The patient had no sexual bleeding, no abdominal pain, bloating, frequent urination and other discomforts.
II. Treatment process
The patient was diagnosed as cervical adenosquamous carcinoma after completing immunohistochemistry upon admission. After gynecological examination, pelvic ultrasound and pelvic MRI, the patient was considered to have cervical adenosquamous carcinoma stage IB1. The patient was not contraindicated to surgery and was recommended to undergo surgery.
III. Treatment results
After the patient was admitted to the hospital for surgical treatment, the postoperative pathological examination revealed: adenosquamous carcinoma of the cervix, invading the cervical canal (depth < 1/3), not involving the uterine cavity upward, not involving the vaginal vault downward, negative vaginal wall margins, and no cancer thrombus in the vasculature. No cancer metastasis was seen in the lymph nodes. There was no indication for additional radiotherapy, and the patient could be closely followed up after surgery. The patient was reexamined one month after discharge, and the surgical wound recovered well, and was advised to adhere to long-term follow-up.
IV. Precautions
After the patient’s condition was controlled, I felt very happy for him and told him that besides actively cooperating with treatment during hospitalization, life management after discharge was also very important. You should pay attention to rest, strengthen nutrition, pay attention to vulva hygiene, keep perineum clean, change underwear regularly, prohibit intercourse for 3 months, and prohibit heavy physical labor for 6 months. If there is chill and fever, abdominal pain and vaginal bleeding, it is necessary to follow up in time.
It is recommended to follow up every 3-6 months for 2 years after treatment, every 6-12 months for the third to fifth year, and once a year after 5 years. Follow-up visits require careful clinical evaluation and informing patients about early signs of recurrence, such as vaginal discharge, weight loss, anorexia, and pelvic, iliac joint, back, or leg pain. Encourage patients to quit or reduce smoking.
V. Personal insight
Early stage cervical cancer mostly has no obvious clinical symptoms. With the progress of the disease, abnormal vaginal bleeding and vaginal discharge may appear, and also symptoms such as frequent urination, urgent urination and constipation may appear due to tumor pressure. It is recommended that women over 25 years old should be screened for cervical cancer regularly. The patient in this case was found to have cervical cancer during routine physical examination, and had no clinical symptoms before diagnosis.