Misdiagnosis and fatal outcome of advanced cervical adenosquamous carcinoma in pregnancy: A case report.

backgroundThe special physiological changes during pregnancy pose a huge challenge to the diagnosis of cervical cancer in pregnancy (CCIP). However, due to the poor prognosis of advanced-stage CCIP, there is currently no consensus or guideline for diagnosis and treatment. CASE SUMMARY: In this case report, we presented the case of a 30-year-old woman at 30 weeks of gestation who presented with irregular vaginal bleeding and was admitted to a local hospital at 35 weeks of gestation with a sudden gush of fluid and underwent a C-section. During the surgery, a rotten fish-like solid mass in the lower segment of the posterior wall of the uterus was excised for biopsy. The patient was referred to our hospital because she experienced heavy vaginal bleeding 13 days after one chemotherapy session. The solid mass was initially misdiagnosed as uterine clear-cell carcinoma at local hospital but later confirmed as cervical adenosquamous carcinoma by a multidisciplinary team. Three months posttreatment, she succumbed to multiple tumor metastases. The infant was healthy at the latest 2-year follow-up.

conclusionObstetricians should expand differential diagnoses when obstetric factors cannot explain symptoms of persistent vaginal bleeding during pregnancy. Atypical and insidious clinical presentations are often concealed by physiological changes during pregnancy, which may increase the difficulty of diagnosis and result in misdiagnosis.