Recurrence during pregnancy of a conservatively treated early-stage cervical squamous cell carcinoma

OBJECTIVE: To evaluate the safety of conservative management of early cervical cancer. DESIGN: Case report and analysis of literature guidelines. SETTING: Academic teaching hospital. PATIENT(S): A 35-year-old, nulliparous woman treated by simple trachelectomy and pelvic lymphadenectomy for a well-differentiated, 12-mm squamous cell carcinoma infiltrating to a depth of 3 mm (stage Ib1) without lymphovascular space involvement. INTERVENTION(S): Follow-up. MAIN OUTCOME MEASURES(S): Recurrence and disease evolution. RESULT(S): Sixteen months after surgery, at 32 weeks' gestation, a local recurrence of 5 cm in diameter was diagnosed, associated with pelvic and interaortocaval lymph node involvement. Despite extensive radiotherapy, chemotherapy, and radical surgery, disease progression could not be halted. CONCLUSION(S): We report a case of early-stage cervical cancer, conservatively treated by simple trachelectomy and lymphadenectomy, that recurred although none of the known risk factors for recurrence were initially present, and despite the fact that literature guidelines were followed.