Radical Hysterectomy for Cervical Cancer in Patients With Uterine Prolapse

Abstract

Background/Aim: Association between cervical cancer and uterine prolapse represents a scarce eventuality. This is a case series of 11 patients diagnosed with different stages of cervical cancer in association with uterine prolapse. Patients and Methods: Between 2014 and 2020, 11 patients were diagnosed with cervical cancer on prolapsed uterine cervix. Results: The mean age of patients at the time of uterine cervix diagnosis was 68 years. In six cases, the first intent treatment was surgery, while in the remaining five cases it consisted of radio-chemotherapy, followed by radical surgery. The perioperative and postoperative outcomes were compared to those reported in a similar series of patients diagnosed in similar stages of the disease, but in the absence of uterine prolapse, no significant differences being encountered. Conclusion: Although it represents an unusual situation, malignant transformation of the uterine cervix might be encountered even in cases presenting uterine prolapse. In such cases, the therapeutic strategy should be tailored according to the stage of the disease. Chronic inflammation is widely accepted to be associated with the development of certain malignancies such as skin, liver or lung cancer (1). When it comes to cervical cancer patients, the relationship between chronic inflammation, malignant transformation, viral infection and uterine prolapse is a controversial one. Women presenting a complete uterine prolapse are predisposed to a long process of chronic inflammation and direct mechanical irritation of the prolapsed areas, increasing in this way the risks of cervical cancer development; therefore, in such cases, special attention should be given to this aspect, and the patients should be routinely submitted to more specific investigations, such as colposcopy, endocervical and exocervical examination, in order to achieve an early diagnosis of the neoplastic disease whenever it develops (1). Furthermore, virology studies have underlined the fact that the displacement of the uterine cervix in cases in which 2073 This article is freely accessible online.

Successful treatment of locally advanced bulky cervical cancer complicated by irreducible complete uterine prolapse

“…[ 4 ] A clear relationship between SCC, verrucous type, and HPV is yet to be described, and HPV infection tends to be infrequent in cases in which uterine prolapse is present. [ 6 ] In our case, HPV was not detected at either the referring hospital or our institution. A systematic review has demonstrated the clinicopathological characteristics of these coexisting conditions.…”

“…[ 8 ] Some authors have suggested that epithelial cornification during uterine prolapse may decrease the risk of malignant transformation. [ 6 , 7 ] Others postulated that irritation of the cervix by being outside the body might promote the development of cancer. Women presenting with complete uterine prolapse are predisposed to a long process of chronic inflammation and direct mechanical irritation of the prolapsed areas, increasing the risk of cancer development.…”

“…Women presenting with complete uterine prolapse are predisposed to a long process of chronic inflammation and direct mechanical irritation of the prolapsed areas, increasing the risk of cancer development. [ 6 , 9 ] In this respect, the prolapse duration may be important for the development of cancer. Prolapse for >10 years may be associated with an increased risk of cancer development.…”

“…Studies have shown that uterine prolapse itself may protect against cervical cancer or it can predispose to malignant transformation of the uterine cervix [8] . Some authors have suggested that epithelial cornification during uterine prolapse may decrease the risk of malignant transformation [6,7] . Others postulated that irritation of the cervix by being outside the body might promote the development of cancer.…”

Synchronous occurrence of HPV-associated cervical squamous cell carcinoma (FIGO IIA) in prolapsed uterus and adenocarcinoma of the anal canal cT1N0M0

“…[4] Correction of this pathology may be a part of the surgical treatment of this tumour. [5][6][7][8][9]…”