title: Curative treatment of a pelvic side wall recurrence after conization for microinvasive cervical cancer stage IA1: a case report and review of the literature.
abstract: BACKGROUND
  For patients wishing to preserve fertility conization is regarded as an adequate treatment in cervical cancer stage IA1 without lymphovascular space involvement (LVSI). Reviewing case series with IA1 cervical cancers without LVSI, lymph node metastasis (LNM) is present in 0.5%.
  
  
  METHODS
  We pr esent a case of a 34-year-old patient treated with conization for squamous cervical cancer invading 1.2 mm without LVSI and horizontal extension of 6 mm (IA1).
  
  
  RESULTS
  At a routine postpartum examination after an uneventful pregnancy, a 5-cm pelvic mass was noted at the right pelvic wall. Intraoperative evaluation revealed a LNM which was resected, and postoperative pelvic chemoradiotherapy was performed. The patient remains recurrence-free 84 months after conization and 73 months after resection of the recurrence.
  
  
  CONCLUSIONS
  Occurrence of LNM in IA1 cervical cancers is very rare, but if early diagnosed curative treatment is possible.
authors.affiliation: Division of Gynecology, Department of Obstetrics and Gynecology, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Konstantin J
authors.initials: KJ
authors.lastname: Dedes
authors.forename: Miltiades
authors.initials: M
authors.lastname: Dedes
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Varga
authors.forename: Dieter R
authors.initials: DR
authors.lastname: Zimmermann
authors.forename: Daniel
authors.initials: D
authors.lastname: Fink
authors.forename: Mathias K
authors.initials: MK
authors.lastname: Fehr
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000821:virology; D003127:Colposcopy; D019092:Conization; D005260:Female; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D010386:Pelvic Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology; D011879:Radiotherapy Dosage; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology