Presentation
Pelvic pain.
Patient Data
A bulky tumour involves the cervix and upper vagina with extension into the parametrial tissues on the left. An abnormally enlarged left pelvic wall lymph node.
Conclusion:
Cervical cancer, FIGO stage IIIC1.
In addition to cervical cancer, there is also increased (pathological) activity in the left pelvic wall lymph node.
The patient went on to have external beam radiation therapy with concurrent chemotherapy, followed by brachytherapy.
A brachytherapy applicator is used to deliver high local dose radiotherapy to the residual but smaller tumour. Vaginal packing and bladder indwelling catheter in situ.
Case Discussion
This patient has locally advanced cervical cancer. A key management-changing threshold in the FIGO staging of cervical carcinoma is IIA vs IIB.
IIA and below tend to be treated surgically, whereas IIB and above require combined EBRT plus brachytherapy.
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