Sustained complete remission of Stage IVb carcinoma of the cervix with cis-platinum, methotrexate and bleomycin chemotherapy

Abstract

The prospects for women with invasive carcinoma of the cervix have changed relatively little over the last 30 years and this has encouraged studies of the addition of chemotherapy to radiotherapy for the treatment of advanced disease. Combination drug treatment can now produce responses in a substantial number of patients with advanced disease, although this is at the cost of toxicity, and the number of durable responses achieved is only small. This should, however, serve to encourage further work, especially since occasional patients may show dramatic benefit. We report such a case. A 42-year-old accountant presented with a history of a smelly, green vaginal discharge and backache. On direct questioning a history of menorrhagia was also elicited. She was para 2 + 0 and had never had a cervical smear. There was no other relevant history. Clinical examination revealed a large tumour involving the cervix and she was admitted for full assessment including examination under anaesthetic (EUA). In theatre, she was seen to be bleeding from a tumour involving the whole cervix and the left parametrium was thickened and fixed to the pelvic side wall.