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Tumor-related internal hemorrhage in late-stage post-chemotherapy cervical cancer patient: case report

Jakub Rzepka, Grzegorz Panek, Mariusz Bidziński, Ryszard Krynicki

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2011, 9 (4), p. 283-288
Streszczenie

Genital tract bleeding is among the most frequent and life-threatening complications of cervical cancer, potentially resulting in severe hemodynamic disturbances, including death. Bleeding may occur at any clinical stage, but is most frequent in women affected with late-stage tumor (FIGO stages IIIB-IVA). There are many literature reports of genital tract bleeding in patients treated by radio- or radiochemotherapy. The past decade provided a large body of evidence indicating high effectiveness of chemotherapy in both adjuvant and neoadjuvant treatment of patients with late-stage cervical cancer. Our experience with chemotherapy in the treatment of locally advanced tumors of various locations confirmed a risk of hemorrhagic complications, which are paradoxically a side effect of an otherwise favorable therapeutic response. The paper reports on an uncommon complication – internal hemorrhage in a patient with FIGO stage IV chemotherapy-treated cervical cancer. Based on this case discussed are conservative and surgical options for controlling genital tract hemorrhage. Prognosis in these patients is very poor; there is always a risk of hemorrhage, independent on treatment modality chosen. Management of internal hemorrhage in patients with genital malignancies poses a considerable challenge for surgeon’s expertise and requires an advanced technical support. The reported further case confirms the necessity of treating cervical cancer patients in multi-specialty centers.

Słowa kluczowe
cervical cancer, genital tract bleeding, internal hemorrhage, chemotherapy complications, iliac vessel ligation