#MedicalCase

CA cervix stage IIIc (Medical oncology)

Pratik Patil., MD GENERAL 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
    General Practitioner

    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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