TITLE: Laparoscopic Modified Radical Hysterectomy and Staging for Uterine Papillary Serous Carcinoma with Cervical Involvement - Objective: To illustrate a case demonstration of laparoscopic modified radical hysterectomy in a patient with uterine papillary serous carcinoma involving the endocervical canal. Methods: This 47 year-old, para-3 woman with no family history of cancer and 3 prior cesarean deliveries presented with postmenopausal bleeding. Endometrial biopsy revealed a mixed poorly differentiated papillary serous and endometrioid carcinoma. On initial examination, a cervical lesion was noted and endocervical curettage was positive for a poorly differentiated adenocarcinoma with squamoid features. Due to the endocervical involvement, modified radical hysterectomy was recommended. All options for management were reviewed with the patient, and she consented to laparoscopic surgical staging. Results: She underwent laparoscopic modified radical hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic and paraaortic lymphadenectomy, and omentectomy without complication. Her total operative time was 330 minutes with a total blood loss of 100cc. She was discharged on postoperative day 3 and had postoperative urinary retention that was treated conservatively until she could void appropriately on postoperative day 14. Final pathology revealed a stage IIIC uterine papillary serous carcinoma. She underwent postoperative chemotherapy with Taxol, Adriamycin, and Cisplatin. She is currently with no evidence of disease at 10 months follow-up. Conclusions: Laparoscopic modified radical hysterectomy with staging as described is a feasible treatment approach and alternative to laparotomy for patients with advanced uterine papillary serous carcinoma. Abs# 9255GYN Authors: Farr Nezhat, MD, Connie Liu MD, Dimitry Lerner MD

• published: 19 Jun 2009
• views: 12855