The Multi-Course Approach of Photodynamic Therapy to Treat Invasive Cervical Cancer IB2: A Case Report

Abstract

Cervical cancer is an important problem in women’s health and a worldwide oncological disease. In 2018, the WHO registered 569,847 new cases in the world, and 3.4% were in the Russian Federation. We describe here a case of invasive cervical cancer stage IB2 associated with human papilloma virus in a woman who was treated by multicourse photodynamic therapy (PDT). A 38-year-old woman presented with abdominal pain and genital tract spotting in October 2015. Colposcopy revealed a neoplasm in cauliflower form. PAP smear result was cancer in situ (Tis). The biopsy result from the cervical canal and neoplasm was invasive squamous cell carcinoma. The patient underwent full preoperative examination (blood test, biochemical blood test, coagulation test, urinalysis, X-ray of chest organs, ECG, ultrasound investigation of pelvic organs, and PAP smear). Magnetic resonance imaging investigation showed a heterogeneous tumor, uneven contours, and intensity accumulating contrast. The patient was not pregnant, and a fertility-preserving treatment method was used. Three PDT sessions allowed to avoid vaginal radical trachelectomy. Pregnancy occurred 3 years and 8 months after the first PDT session. The patient had testing after treatment 4 times (3rd, 12th, 24th, and 60th months). She had a pregnancy without complications and had operative delivery by Cesarean section in April 2020. There was a 5-year remission period without episodes of relapse. The patient has an 8-month-old baby.