VP66.22: Transvaginal colour Doppler ultrasound as diagnostic modality in decision‐making for cervical cancer in pregnancy: a case report

Abstract

A 38-year-old G42 (2012) diabetic was diagnosed with squamous cell carcinoma of the cervix and opted for preservation of pregnancy. Her Pap smear in the first trimester revealed atypical glandular cells of undetermined significance. Cervical punch biopsy done at 20 weeks showed squamous cell carcinoma, which was clinically staged as Stage IB2. Transvaginal colour Doppler sonography at 33 weeks revealed a 3cm hypoechoic mass in the posterior cervix, with absence of parametrial invasion. Colour Doppler ultrasound demonstrated abundant vascularisation. Counselling was done, and patient opted to deliver near term. After a course of corticosteroids, and a repeat scan revealing no progression of invasion, the patient underwent classical Caesarean section with Radical Hysterectomy, Bilateral Salpingo-oophorectomy, Bilateral Lymph Node Dissection at 36 weeks gestation. Patient delivered to a healthy baby boy who had an unremarkable postnatal course. Gross examination revealed a tumour at the posterior cervix, with no involvement of the uterine corpus and parametria. Biopsy showed invasive squamous cell carcinoma, large-cell non-keratinizing, with no parametrial infiltration. This case shows that although there is a risk of tumour progression, delaying definitive treatment may be done in early stage disease to improve fetal survival. The multidisciplinary team, guided by prenatal ultrasound, can assess tumour invasion and make decisions for timing of delivery and extent of surgery, in order to ensure the best maternal and fetal outcomes. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.