Radio therapy

The researches find that the vaginal cancer that was associated with complete uterine prolapse and complicate by severe intrauterine adhesions. In this case report; therefore they describe the clinical course and successful treatment of this rare condition. Because A 78-year-old woman (gravida 10, para 2, abortion 8) ;with a 10-year history of uterine prolapse presented for evaluation of bleeding from an ulceration on the surface of the irreducibly prolapsed uterus.

Complete uterine prolapse

Biopsy of a mass on her vaginal wall led to a diagnosis of keratinizing squamous cell carcinoma. Her history of eight abortion procedures had resulted in severe intrauterine adhesions; But  preventing tandem insertion and intracavitary brachytherapy. She was also ineligible for surgery under general anesthesia + chemotherapy because of her advanced age and presence of arrhythmia. Therefore; They devised an extensive treatment plan involving high-dose-rate interstitial brachytherapy.

This treatment successfully eliminated the squamous cell carcinoma as confirmed by biopsy with no recurrence or severe late complications. Among various types of pelvic organ prolapse, uterine prolapse is occasionally observe in parous women and women of advance age. When mild cases of uterine prolapse are include, the incidence is report to range widely from 2.9 to 93.6% among women in the general population.

The squamous cell carcinoma

The literature contains sporadic reports of uterine cervical cancer in women with uterine prolapse. The standard treatment options for medically inoperable uterine cervical cancer are pelvic external beam radiation therapy (EBRT) and brachytherapy (BT). They encounter a woman of advance age with vaginal cancer associated with complete uterine prolapse, for which BT was plann.

The patient had a history of several abortion procedures, and the resultant severe intrauterine adhesions prevented insertion of the tandem. Therefore, They plan high-dose-rate (HDR) interstitial BT (ISBT), in which plastic needles are directly insert under direct visual observation to surround the margin of the ulcerate lesion of the vaginal cancer associate with complete uterine prolapse.

Several abortion procedures

After insertion of the plastic BT needles, dummy sources are insert and computed tomography (CT) is perform. Using a treatment planning system, dose–volume histogram analysis was perform to develop a plan for covering the lesion, and HDR ISBT is administer.

Very few reports have describe detailed irradiation procedures for radiation therapy (RT) in the treatment of vaginal or uterine cervical cancer associated with uterine prolapse.  Furthermore, this is the first reported case of this condition complicate by intrauterine adhesions. We found that high-dose-rate interstitial brachytherapy may be a very effective therapeutic strategy for this condition with few adverse effect