After uterine cancer, ovarian cancer is the second most common female reproductive tract malignancy. In Poland, in 2015, there were 3735 new cases and 2738 deaths from ovarian cancer. Over 80% of all cases are diagnosed in women aged over 50, whereas only 6% – before 35 years of age. Most cases are diagnosed, when clinical symptoms have already appeared, and the disease is at least locally advanced. The case presented below describes a very young 28-year-old woman with a tumour in the pelvis, ascites and very high Ca 125 and HE 4 levels. The clinical symptoms as well as laboratory and imaging tests were suggestive of epithelial ovarian cancer that required urgent surgery due to progression of the disease. The surgery posed a significant risk of complications, but owing to the deterioration of the patient’s condition it was considered necessary. The patient was born with a severe, complex heart defect, had undergone two cardiac surgeries, and had a pacemaker (first VVIR, then DDD). She was also intensively treated for iatrogenic HCV infection and hypothyroidism. A multidisciplinary team (a gynecologist, cardiologist and anesthetist) were behind the decision to carry out a major gynecological operation which ended with success. For the past 6 years, the patient has been under constant oncological follow-up and enjoys a good health.
The presented case report is an example of a spectacular effect of induction systemic treatment in a patient with locally advanced cervical cancer of IB2 grade according to FIGO 2009 (International Federation of Gynecologist and Obstetrician). The effect of induction chemotherapy (three series in paclitaxel/24 h + cisplatin regimen at an interval of three weeks) was the total metabolic response of the primary tumor and nodal lesions found in FDG-PET/CT (18F-fluorodeoxyglucose – positron emission tomography combined with computed tomography) as well as an image of total regression of the tumor in the obtained postoperative histopathological examination.
PL
Przedstawiony opis przypadku jest przykładem spektakularnego efektu zastosowania chemioterapii neoadiuwantowej (NACT, neoadjuvant chemotherapy) u pacjentki z miejscowo zaawansowanym rakiem szyjki macicy w stopniu IB2 według FIGO 2009 r. (International Federation of Gynecologist and Obstetrician). Efektem zastosowanej chemioterapii indukcyjnej (trzech serii w schemacie paklitaksel/24 h + cisplatyna w odstępie 3-tygodniowym) była całkowita odpowiedź metaboliczna guza pierwotnego i zmian węzłowych stwierdzona w badaniu FDG-PET/CT (18F-fluorodeoksyglukoza – pozytonowa tomografia emisyjna połączona z tomografią komputerową), a także obraz całkowitej odpowiedzi patologicznej w otrzymanym pooperacyjnym badaniu histopatologicznym.
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