#MedicalCase

CA cervix stage IIIc (Medical oncology)

Dr. Pratik Patil., MD ( INTERNAL MEDICINE)

 

Medical Case Details:

45 years old lady, a diagnosed case of Carcinoma cervix, stage IIIC. She completed EBRT 50 Gy with one cycle of concurrent chemotherapy with Cisplatin. Further cisplatin not given due to toxicities. She also received 4# brachytherapy till 31.10.2019.

On follow up USG showed a metastatic deposit in right external iliac region. CT scan was done to assess the nodal status which showed a retrocaval lymphnode about 16.3X12.8 mm as new findings. It showed no evidence of recurrent lesion in cervix.

She was planned for 6 cycles of chemotherapy with Paclitaxel and Carboplatin.

After 4 cycles of chemotherapy till 14.5.2020 PET CT scan done . Findings are:

a) Two hypodense mildly enhancing FDG avid lesion in right lobe of liver (SUV max - 2.9 & 3.2).

b) Hypodensity of endometrial lining (SUV max- 5.5)

Two mixed densities area with non homogenous FDG uptake is seen in the pelvic cavity on right side (SUV max 6.5 : 15X13 mm) and on left side (SUV max 3.6, 18X13 mm).

What should be the next plan?

 


    Discussions


    Dr. Kushal Sen

    AS THE FINDINGS ARE INDICATIVE OF PD POST 4 CYCLE CHEMOTHERAPY, IN THIS METASTATIC SETTINGS , WE CAN WARRANT FOR IMAGE GUIDED HISTOLOGY FROM LIVER LESIONS ( SUV values are low)
    2. We have to plan for 2nd line chemotherapy, Bevacizumab may be added in combination with topotecan or DOCE / CIS /BEVA MAY BE EXPLORED..
    THERE ARE TRIAL WITH PAZOPANIB BUT STILL NOT FULL PROVED
    IMMUNOTHERAPY IS ANOTHER OPTION...

    ▲ 1
    23.Jun, 03:30pm



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