Undiagnosed Cervical Cancer After Total Abdominal Hysterectomy In North Central Nigeria-Case Report

Abstract

Back ground: Total abdominal hysterectomy (TAH) is a commonly performed surgical procedure by many doctors in the developing world, for reasons ranging from mild benign to severe malignant conditions. This is because they are often confronted with cases where treatment has to be offered to their patients either due to lack of facilities and / or personnel for appropriate diagnosis or pressure and anxiety from clients and relatives, resulting in cases of undiagnosed cervical malignancy. Many of which could have been treated differently if properly diagnosed.Objective: This study was to evaluate the uterine specimen obtained after TAH and bilateral salpingo-oopherectomy (BSO) for undiagnosed cervical bleeding for unexpected histology.Design/ methods: This was a retrospective study design. The case of a 58-year old woman with post coital bleeding who was anxious to have hysterectomy for fear of cervical cancer was analyzed after surgery with the histology report of the surgical (TAH/BSO) specimen .Result: She had TAH/BSO with excision of a cuff of the vagina. The histology of the specimen showed evidence of early locally invasive cancer of the cervix. The surgical margins were microscopically disease free. She was referred for radiotherapy at a regional centre in Nigeria (Ibadan) where she had teletherapy and two years of outpatient followup showed no recurrence or complications.Conclusion: Cases of invasive cervical cancer usually present late in this part of the world with surgical treatment not considered an option. We present a case of undiagnosed early cervical cancer in a postmenopausal woman who had successful TAH/BSO and postoperative radiotherapy. Preventive screening measures coupled with accurate diagnosis, and the improvement in manpower and facilities have been known to give better results. This is a reminder to all doctors and gynecologists of the need for cervical screening, in our hospitals.