title: Intractable recurrent cervical cancer with pelvic bone involvement successfully treated with external hemipelvectomy.
abstract: The indication of external hemipelvectomy for lateral recurrent cervical cancer involving the pelvic bone is controversial. We report the second longest surviving patient of recurrent cervical cancer successfully treated by external hemipelvectomy. A 38-year-old woman who had undergone conization for stage Ia1 cervical cancer six years earlier had severe right inguinal pain. A large multicystic recurrent tumor was identified in the right obturator region. After chemotherapy and chemoradiation, the tumor regressed, but soon relapsed. The patient's symptoms flared and the tumor was enlarged involving the right iliac bone. We performed right external hemipelvectomy with amputation of the right lower extremity, right iliac wing and ischiopubic bone. There was no major complication after the operation and the patient was discharged on postoperative day 48. After 27 months of follow-up, she has no complaints and is without evidence of recurrence. In selected cases of intractable lateral recurrent cervical cancer with pelvic bone involvement, relief from tumor-related pain and a possibility of prolonged survival can be expected by external hemipelvectomy.
authors.affiliation: Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Junzo
authors.initials: J
authors.lastname: Hamanishi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Higuchi
authors.forename: Masaki
authors.initials: M
authors.lastname: Mandai
authors.forename: Ken
authors.initials: K
authors.lastname: Fukuhara
authors.forename: Masae
authors.initials: M
authors.lastname: An
authors.forename: Tomitaka
authors.initials: T
authors.lastname: Nakayama
authors.forename: Kenji
authors.initials: K
authors.lastname: Takakura
authors.forename: Shingo
authors.initials: S
authors.lastname: Fujii
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D019092:Conization; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010384:Pelvic Bones / Q000473:pathology / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D011859:Radiography; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery