175 Radiation: cure or curse? A case report on radiation-induced endometrial cancer after cervical cancer treatment

Abstract

Radiation-Induced Malignancies (RIM) are rare clinical entities that encompass different histological types, majority being high grade and deep tumors with worse prognosis, hence becoming a therapeutic challenge. The reported incidence of an endometrial cancer developing after radiation therapy for cervical cancer is 0.5% – 0.8%. After a thorough literature search, this probably is the first case of endoemtrial cancer reported as a second primary malignancy following radiation therapy for cervical cancer in the local setting. A 60 - year old para 4 was diagnosed with Stage llB squamous cell carcinoma of the cervix who underwent concurrent chemoradiotherapy with brachytherapy. She had an incidental history of chronic Hepatitis B infection and Rheumatic Heart Disease. She remained asymptomatic with no evidence of disease for 11 years until abdominal pain ensued. A transvaginal ultrasound showed fluid - filled uterine cavity and intracavitary mass. On exploratory laparotomy, peritoneal fluid cytology, extrafascial hysterectomy with bilateral salpingo-oophorectomy, resection of rectal mass and biopsy of mesenteric implants were performed. Final histopathology revealed an advanced stage adenosquamous carcinoma of the endometrium.