Neoadjuvant chemotherapy followed by cesarean radical hysterectomy in a triplet pregnancy complicated by clear cell carcinoma of the cervix: a case presentation and literature review.
OBJECTIVE
To report a triplet pregnancy complicated by clear cell cervical carcinoma that was managed using neoadjuvant chemotherapy followed by caesarean radical hysterectomy.


METHODS
A 26-year-old woman had a diagnosis of cervical clear cell carcinoma, which was International Federation of Gynecology and Obstetrics stage IB1, at 18 weeks of gestation during a triplet pregnancy. Owing to the patient's strong desire for full-term pregnancy, 3 cycles of neoadjuvant chemotherapy was administered after magnetic resonance imaging evaluation of the tumor. The patient underwent cesarean delivery and radical hysterectomy at gestational week 32. The hysterectomy specimen revealed stage IB1 clear cell adenocarcinoma of the cervix. The neonates and the mother did not have any complications related to the treatment during 36 months of follow-up.


CONCLUSIONS
To the best of our knowledge, this is the first report of a triplet pregnancy complicated by cervical clear cell carcinoma that was successfully treated with neoadjuvant chemotherapy and cesarean radical hysterectomy. Our experience and literature review suggest that neoadjuvant chemotherapy for cervical carcinoma diagnosed during pregnancy is associated with excellent oncologic and fetal outcome; therefore, it may be considered as a temporary fertility-sparing approach in selected patients with a strong desire for full-term pregnancy. Nonetheless, additional research and long-term follow-up are needed to reach a more definitive conclusion.
Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey.
Ali
A
Ayhan
Polat
P
Dursun
Burcu Kisa
BK
Karakaya
Ozlem
O
Ozen
Cagla
C
Tarhan
D018262:Adenocarcinoma, Clear Cell / Q000150:complications / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002585:Cesarean Section; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007231:Infant, Newborn; D020360:Neoadjuvant Therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D059286:Pregnancy, Triplet; D011379:Prognosis; D012196:Review Literature as Topic; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*
D000970:Antineoplastic Agents; D002945:Cisplatin