Case Conference March, 28th 2012

29-Mar-2012, Divisi Ginekologi Onkologi RSCM

Oncology case conference march 28th 2012

Mrs. S, 48 yo,  

Cervical Carcinoma Stage IB1 post radical hysterectomy

Fistula ureterovagina

•       Came with review PA result: Squamous cell carcinoma keratinized moderate-poor differentiation. there was vascular invasion (+)

•       History of radical hysterectomy (Jan 30 2012) due to cervical cancer IB1

•       Still could not  spontaneously micturition, urine leakage (+)àfistula ureterovagina, pro fistula repair

General status

•       BP 110/70 mmHg              Pulse 90x/min   RR 20x/min         T afebrile

•       Height 153 cm    BW 58 kg             

•       Conjunctiva        : not anemic

•       Heart/lung          : wnl

•       Abdomen            : supple, tenderness (-), operation scar (+)

•       Extremities         : edema -/-

Gynecological status

·         Inspection   : wnl

·         Inspeculo    : vaginal stump smooth, no mass

·         VRE                                : no mass palpated, vaginal stump smooth, TSA  wnl, smooth rectal mucosa

Diagnosis

•        Post radical hysterectomy due to cervical cancer IB1

•       Fistula uretero vagina

Problem

•       PA result: Squamous cell carcinoma keratinized moderate-poor differentiation. there was vascular invasion (+)àradiation

•       When to perform radiation, before or after fistula repair?