Uterus didelphys and cervical cancer: A case report

Area of Science:

• Gynecologic Oncology
• Reproductive Medicine
• Embryology

Background:

• Müllerian malformations arise from abnormal paramesonephric duct development, affecting female reproductive organs.
• Co-occurrence of Müllerian malformations with cervical cancer is rare, lacking standardized oncologic management protocols.
• Urogenital anomalies present unique challenges in diagnosing and treating gynecologic malignancies.

Observation:

• A 41-year-old asymptomatic woman with atypical glandular cells (AGC-FN) and HPV 16 positivity was diagnosed with cervical intraepithelial neoplasia (CIN) III.
• Incidental findings included uterus didelphys and left renal agenesis.
• The patient underwent cervical conization, diagnosed with squamous cell carcinoma of the cervix, and received guideline-compliant treatment.

Findings:

• Successful guideline-compliant treatment for early-stage cervical cancer was achieved in a patient with uterus didelphys.
• A customized indocyanine green (ICG) injection protocol was employed for sentinel lymph node examination, adapted to patient's anatomy.
• Laparotomic hysterectomy (Piver type II) following staging laparoscopy with sentinel lymphadenectomy was performed.

Implications:

• Individualized therapy planning is crucial for managing gynecologic carcinomas in patients with Müllerian malformations.
• Anatomical peculiarities necessitate customized surgical and oncologic approaches.
• Protective measures for renal function are imperative when urinary tract anomalies are present concurrently.