Radical vaginal trachelectomy after supracervical hysterectomy.
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.
Mendez
Luis E
LE
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Miami School of Medicine, Jackson Memorial Medical Center, Miami, Florida, USA.
Penalver
Manuel
M
McCreath
Wayne
W
Bejarano
Pablo
P
Angioli
Roberto
R
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