A case report of successful pregnancy after radical trachelectomy

Abstract

Introduction Cervical cancer, as a global health problem, is most commonly associated with HPV infection. The incidence is rising among women of reproductive age. The challenge is that standard treatment is radical hysterectomy that remains a serious problem for women who still wish to conceive. Fertility-sparing surgery is possible in strictly controlled cases, but pregnancy afterwards is still an issue.

Case outline A 32-year-old, nulliparous patient with a diagnosis of early-stage invasive squamous cell cervical cancer is presented. After evaluation and only after selection criteria were met, radical abdominal trachelectomy with pelvic lymph node dissection was performed. Final histological diagnosis revealed that cancer infiltrated the entire depth of the specimen, with malignant cells present at the lateral resection margin. Radical hysterectomy was indicated, but the patient refused. After a year, the patient conceived spontaneously and had a successful pregnancy.

Conclusion The fertility-sparing treatment for early-stage cervical cancer is an oncologically safe option in carefully selected patients. The pregnancy afterwards remains high risk and needs close follow-up to optimize both maternal and fetal outcomes.

Keywords: cervical cancer; fertility-sparing treatment; pregnancy