title: Radical vaginal trachelectomy after supracervical hysterectomy.
abstract: BACKGROUND
  Radical vaginal trachelectomy (RVT) is an acceptable approach when applied toward a select group of patients with early stage cervical carcinoma. It is less invasive, can maintain fertility, and can be ideal in patients with significant comorbid factors compared to abdominal approaches. A small subset of patients with a previous supracervical hysterectomy can pose a surgical dilemma.
  
  
  METHODS
  An 81-year-old woman with a history of severe cardiac disease on routine gynecological examination was found to have adenocarcinoma in situ with a focus suspicious for invasion of the cervical stump diagnosed by cone biopsy. She previously had a supracervical hysterectomy for benign disease of the uterus. A RVT was performed as definitive treatment and the patient recovered without complications.
  
  
  CONCLUSIONS
  In the rare case that presents with a history of supracervical hysterectomy, RVT with some technical modifications can still be considered as a therapeutic option for early stage cervical carcinoma.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Miami School of Medicine, Jackson Memorial Medical Center, Miami, Florida, USA.
authors.forename: Luis E
authors.initials: LE
authors.lastname: Mendez
authors.forename: Manuel
authors.initials: M
authors.lastname: Penalver
authors.forename: Wayne
authors.initials: W
authors.lastname: McCreath
authors.forename: Pablo
authors.initials: P
authors.lastname: Bejarano
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014591:Uterine Diseases / Q000601:surgery; D014621:Vagina / Q000601:surgery