Background: Villoglandular adenocarcinoma of the cervix is a rare condition that appears in young women and is characterized by its low aggressiveness. The most common treatment is surgery, consisting of either a conization or hysterectomy. Ovaries may be preserved depending upon the patient's reproductive desires. Case: The case reported here involves the recurrence of a stage IB1 villoglandular adenocarcinoma of the cervix. This may be the first case report of the recurrence of a villoglandular adenocarcinoma of the cervix with no lymph node metastasis following a radical hysterectomy, and the first case of a laterally extended endopelvic resection being complicated by an arterial thrombosis. Results: Resection was performed, leaving part of the residual tumor. The patient experienced a postoperative thrombosis of the left common iliac artery. A fasciotomy of the tibia and calf was performed, followed by a femoro-femoral crossover bypass. The patient is still undergoing rehabilitation, as well as chemotherapy and radiotherapy, and is being monitored. Conclusions: This case report is of importance because it is the first that describes the recurrence of a villoglandular adenocarcinoma of the cervix without lymph node metastasis, treated by side pelvic wall surgery that was complicated by arterial thrombosis. (J GYNECOL SURG 28:227)
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References
1.
KakuT, KAmuraT, SakaiK, NakamiNet al.Adenocarcinoma of the uterine cervix with predominantly villoglandlar papillary growth pattern. Gynecol Oncol, 1997; 64:147.
2.
JonesMW, SilverbergSG, KurmanRJ. Well-differentiated villoglandular adenocarcinoma of the uterine cervix: A clinicopathological study of 24 cases. Int J Gynecol Pathol, 1993; 12:1.
3.
QuerleuD, MorrowCP. Classification of radical hysterectomy. Lancet Oncol, 2008; 9:297.
4.
O'Sullivan, GJ, Semba, CP, Bittner, CA, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol, 2000; 11:823.
5.
FriedlanderM, GroganM. Guidelines for the treatment of recurrent and metastatic cervical cancer. Oncologist, 2002; 7:342.
6.
WangCJ, LaiCH, HuangHJ, HongJH, ChouHH, HuangKG, LinJD. Recurrent cervical carcinoma after primary radical surgery. Am J Obstet Gynecol, 1999; 18:518.
7.
HöckelM, BaubmannE, MitzeM, KnapsteinPG. Are pelvic-side wall recurrences of cervical cancer biologically different from central relapses?Cancer, 1994; 74:648.
8.
TanGC, ShiranMS, SwaminathanM, AishahMAS, OngP, DaliM, HattaAZ. Villoglandular papillary adenocarcinoma of the uterine cervix with lymph node metastases: A case report and review of the literature. Med Health, 2006; 1:85.
9.
AustinKK, SolomonMJ. Pelvic exenteration with en bloc iliac vessel resection for lateral pelvic wall involvement. Dis Colon Rectum, 2009; 52:1223.
10.
YamadaK, IshizawaT, NiwaK, ChumanY, AkibaS, AikouT. Patterns of pelvic invasion are prognostic in the treatment of locally recurrent rectal cancer. Br J Surg, 2001; 88:988.
