The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

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POSTERIOR PELVIC EXENTERATION FOR ADVANCED, UNRESPONSIVE TO RADIATION THERAPY CERVICAL CANCER - A CASE REPORT

2014-03

N. Bacalbașa, Irina Bălescu

Although pelvic exenterations represent aggressive surgical procedures which might associate physical and psychological problems and a worsened body image, they are the only potential solution with curative intent in centro-pelvic tumors originating from both digestive and gynecologic tract. (1,2,3) In selected cases preoperative oncologic treatment can offer a tumor down-staging or can diminish the tumoral invasion in adjacent organs providing this way the possibility of less aggressive surgical procedures. In other cases this desiderate cannot be obtained; the tumor proves to be unresponsive to neo-adjuvant treatment and multivisceral resections being needed in order to obtain a good control of the disease. Studies have shown that clinical features of the tumor and both molecular and non-molecular biomarkers can be responsible for the poor tumoral response at irradiation. (4) In these cases surgery remains the only treatment with curative intent. We present the case of a 62 year old patient diagnosed with a large cervical tumor in which neo-adjuvant treatment failed to obtain an acceptable control of the disease. She was addressed to our service after augmentation of the tumor under neo-adjuvant treatment; we performed a total hysterectomy en bloc with bilateral adnexectomy, total colpectomy, abdomino-perineal rectal resection and pelvic lymph node dissection with good results.

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