Case Conference August 15th 2012

15-Aug-2012, Divisi Ginekologi Onkologi RSCM

Cervical Carcinoma  Stage III B  Post Complete Chemoradiation 2008, with Paraaorta Lymphadenophaty dd/ Malignum Lymphoma, Specific Process

 

Identity

Mrs LAP,  P4, 47yo, 3179553

 

10 dec 2007

S:Refered by Tangerang hospital due to cervical cancer IB. Patient complained vaginal and post coital bleeding since 2 months . Clinically exophytic mass 3x3x2 cm,loose parametrium, PA: non keratinizing squamous cell carcinoma  well differentiated  grade 2, no LVSI

Lost follow up

9/10/2008,

Patient came again to RSCM, and staging as cervical cancer III B , got chemotherapy Platosin  2 series (24/11/2008 and 10/12/2008) and complete radiation(ER 10/11 2008 -16/12 2008à 25 x, IR 19/1/2009 - 5/2 2009à 3x).

28/06/2010

Patient controled after chemoradiation ,clinically no evidence disease , performed papsmear , with cytology  result (101793), negative, no malignant cell.

21/4/11

patient had ct-scan abdomen with result : right cervical lession 1,9x1,8 cm  dd/ fibrosis. Clinically: smooth portio, shortened vagina 3-4 cm ,VRT: cut b/u n. Smooth portio and vaginal wall, loose parametrium and US result (25 April 2011): No intra pelvic mass

7/8/12

patient came to policlinic with ct-abdomen : Bilateral paraaortic limphadenopathy as high subpancreas until inferior pole of renal dd/ malignum lymphoma, spesific process.

Clinically no evidence diseasase.

 

Discussion with Dr.Andi Darma Putra, obgyn(C)

Patient with cervical  carcinoma IIIB, post chemotherapy and complete radiation ( last:5/2/2009), with Bilateral paraaortic limphadenopathy dd/ malignum lymphoma, specific process, alternatif :

·        Paraaorta lymphadenophaty byopsi guided CT with risk/complication

·        No treatment

 

Discussion in CC