TY - JOUR 
A1 - Sánchez Cuerda, Cristina
AU - Cuadra, María
AU - Gamir Henderson, Susana
AU - Lobo Abascal, Paloma
AU - Elices Apellániz, Margarita
AU - Cabrera Guerra, Yasmina
T1 - Cervical adenocarcinoma in situ during pregnancy and subsequent fertility-sparing therapy challenge
Y1 - 2022
SN - 1879-3479

UR - http://hdl.handle.net/11268/11541
AB - Objective: Adenocarcinoma in situ (AIS) of the cervix is a premalignant lesion, and a precursor of invasive disease. It is less frequent than its squamous counterpart. During pregnancy, AIS is a scarcely described scenario, whose diagnosis barely differs from non-pregnant patients. Its management is challenging with hysterectomy being the definitive treatment. However, its high incidence in young patients makes fertility-sparing management an approachable option for selected patients. The objective of this study is twofold. Firstly, we describe a case of a patient with AIS during pregnancy and the postpartum period. Secondly, the available literature is reviewed.

Methods: Retrospective medical record review of a single case and a medical literature search in Pubmed of AIS cases in pregnant women.

Results: A 31-year-old woman with cervical AIS diagnosed during pregnancy underwent serial fertility-sparing surgeries including a loop electrosurgical excision procedure and endocervical curettage during the second trimester, and a re-conization and a simple traquelectomy during the postpartum period, until negative margins were achieved. Upon reviewing the literature from 1965 to 2020, 23 other cases were found.

Conclusion: Surgical management of cervical AIS during pregnancy is a safe procedure. Subsequent conservative surgeries imply a real challenge to preserve fertility.
KW - Colposcopía
KW - Prueba de Papanicolaou
KW - Displasia del cuello del útero
KW - Salud
KW - Embarazo
KW - Cáncer
LA - eng
ER -