Human Papillomavirus Caused Cervical Cancer Detected During Pregnancy

On the operating table is a young patient Nadezhda 32 years old from the Tula region, who was diagnosed with cervical cancer in the first trimester of pregnancy. From the anamnesis it is known that in 2016 the girl was diagnosed with HPV type 16, which refers to highly oncogenic. When she became pregnant, during a routine checkup, doctors detected a polyp-like formation of the cervix and sent her for consultation to an oncogynecologist. After performing colposcopy (diagnostic examination with the help of binoculars and light) and taking into account the patient’s position, the doctors decided not to perform a biopsy, but against the background of increasing gestational age, there was an increase in the cervical polyp formation.

Already in August 2023 Nadia became a mom and after some time continued the examination. Having performed a biopsy, the specialists confirmed the malignant process of squamous cell cancer of the cervix. Nadezhda did not waste time and turned to the FSBI “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation, where they agreed to help her and decided to perform radical surgery.

“Given the stage of the tumor process, we have to perform radical nerve-sparing hysterectomy or Wertheim’s operation, which involves removal of the uterus, cervix, parametrium (tissues near the cervix and vagina), and lymph nodes in the pelvis. The young age of the patient, the absence of changes in the ovaries, the stage of the tumor process, makes it possible to save the ovaries, which will be transplanted into the abdominal cavity. This will preserve the hormonal background,” commented during the operation Svetlana Mukhtarulina, Head of the gynecologic department with chemotherapy at the N.A. Lopatkin Research Institute of Urology and Interventional Radiology.

We use an advanced method of patient treatment, which was developed at our Center and patented. Its undeniable advantage is the preservation of patients’ quality of life due to the fact that side effects from the urinary system are minimized.

But in the first stage, surgeons perform the identification of signal lymph nodes directly during the operation, i.e. those lymph nodes that are the first to accumulate contrast during the study.

“Our Center is included in the protocol of a clinical trial approved by the Russian Ministry of Health, the national coordinator of which is the Director General of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation Andrey Kaprin, explains Svetlana Valeryevna. It is aimed at assessing the diagnostic efficacy of intrathecal route of administration of Indocyanine Green in the detection (identification) of signaling lymph nodes in endometrial cancer stage 1 and cervical cancer stages 1 and 2”. After the dye is injected an average of 618 minutes later, surgeons see a glow of signaling lymph nodes, which are removed and then examined by pathomorphologists. “Essentially, we are talking about accurate diagnosis in the area of regional metastasis. Since the absence of pathological changes in the signaling lymph nodes, it is very likely that there are no metastases in the pelvic lymph nodes”.

Later, the results of histologic examination will be known, which will determine the further tactics of treatment of the patient and remove the question of the need for radiation therapy. “I would like to remind once again about the importance of preventive examinations and timely diagnosis of HPV infection in young women, summarizes Svetlana Valerievna. A good specialist will not only detect the problem in time, but also prescribe the right treatment”.