Cervical Adenocarcinoma in Pregnancy with a Concomitant Papillary Adenocarcinoma of the Thyroid Gland: A Case Report

Abstract

Introduction: Cervical cancer in pregnancy is a rare disease, with an incidence of 0.01-0.1%, of which most are squamous epithelial cancers. We here present the first case of a uterine cervical adenocarcinoma during pregnancy with a concomitant papillary adenocarcinoma of the thyroid gland. Materials and Methods: Data were extracted from the patient’s records. Literature review was performed using the databases PubMed, Web of science and Embase. Case Report: A 36-year-old Gravida IV, Para III was admitted to the Cantonal Hospital St. Gallen, Switzerland with an invasive adenocarcinoma of the uterine cervix cT1B2 cNx Mx G1 ER neg PR neg Ki67 80% at 31 weeks of gestation. She was treated with 2 cycles of neoadjuvant chemotherapy (carboplatin and paclitaxel). Following caesarean section at 36 2/7 weeks of gestation, treatment was switched to chemoradiation therapy. The patient delivered a healthy girl. A concomitant papillary thyroid cancer pT1a, pN1a (1/6) was successfully treated by surgery. The patient is free of recurrence and metastasis at 4.5 years of follow-up for either of the tumors. Conclusion: Management of cervical cancers in pregnancy has to be individualized based on factors like gestational age, stage and histology of the cancer, and the wish for pregnancy continuation or termination. Neoadjuvant chemotherapy seems to be a reasonable option to postpone radical surgery or chemoradiotherapy to prevent preterm delivery. To the best of our knowledge, this is the first report of a cervical adenocarcinoma in pregnancy with a concomitant papillary thyroid cancer.