Alzibdeh A, Mohamad I, Wahbeh L, Abuhijlih R, Abuhijla F. Can we triumph over locally advanced cervical cancer with colossal para-aortic lymph nodes? A case report. World J Clin Cases 2024; 12(10): 1851-1856 [PMID: 38660077 DOI: 10.12998/wjcc.v12.i10.1851]
Corresponding Author of This Article
Fawzi Abuhijla, MD, MSc, Assistant Professor, Department of Radiation Oncology, King Hussein Cancer Center, Queen Rania St. PO Box 1269, Amman 11941, Jordan. fhijle@khcc.jo
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2024; 12(10): 1851-1856 Published online Apr 6, 2024. doi: 10.12998/wjcc.v12.i10.1851
Can we triumph over locally advanced cervical cancer with colossal para-aortic lymph nodes? A case report
Abdulla Alzibdeh, Issa Mohamad, Lina Wahbeh, Ramiz Abuhijlih, Fawzi Abuhijla
Abdulla Alzibdeh, Issa Mohamad, Lina Wahbeh, Ramiz Abuhijlih, Fawzi Abuhijla, Department of Radiation Oncology, King Hussein Cancer Center, Amman 11941, Jordan
Author contributions: Alzibdeh A and Abuhijla F designed research concept, reviewed the literature and wrote the manuscript; all author have edited the manuscript; all authors have read and approved the final version of the manuscript.
Informed consent statement: Informed consent obtained from the patient.
Conflict-of-interest statement: All authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fawzi Abuhijla, MD, MSc, Assistant Professor, Department of Radiation Oncology, King Hussein Cancer Center, Queen Rania St. PO Box 1269, Amman 11941, Jordan. fhijle@khcc.jo
Received: January 23, 2024 Peer-review started: January 23, 2024 First decision: January 31, 2024 Revised: February 4, 2024 Accepted: March 18, 2024 Article in press: March 18, 2024 Published online: April 6, 2024
Abstract
BACKGROUND
Para-aortic lymph nodes (PALNs) are common sites for the regional spread of cervical squamous cell carcinoma (SCC).
CASE SUMMARY
We report the case of a 36-year-old woman who presented with cervical SCC with multiple bulky PALNs, largest measured 4.5 cm × 5 cm × 10 cm. The patient was treated with radical intent with definitive chemoradiation using sequential dose-escalated adaptive radiotherapy, followed by maintenance chemotherapy. The patient achieved a complete response; she has been doing well since the completion of treatment with no evidence of the disease for 2 years.
CONCLUSION
Regardless of the size of PALN metastases of cervical carcinoma origin, it is still treatable (with radical intent) via concurrent chemoradiation. Adaptive radiotherapy allows dose escalation with minimal toxicity.
Core Tip: In rare case of locally advanced cervical cancer with massive para-aortic lymph node involvement, we demonstrated successful treatment with concurrent chemoradiotherapy, achieving a complete response without surgery. Our study underscores the challenge of managing such cases because of the limited evidence on the optimal radiation doses for bulky lymph nodes. Despite this, our case highlights the potential efficacy of high-dose radiation, and the importance of multidisciplinary collaboration in treatment planning. Further research is warranted to refine treatment strategies and improve outcomes in similar cases.
