Intracavitary brachytherapy challenge in cervical cancer with a large cervical fibroid: A case report

ABSTRACT

Among women, cervical cancer continues to be a significant cause of cancer-related death, especially in low- and middle-income nations. Brachytherapy (BT), which provides excellent tumor dose delivery while preserving surrounding tissues, is an essential part of the treatment for locally advanced cervical cancer. Anatomical issues, such as large cervical fibroids, may complicate the placement of the intracavitary brachytherapy (ICBT) applicator. We describe a 74-year-old woman whose stage IIIB cervical cancer was complicated by a large cervical fibroid, which presented a significant BT issue. The successful management of this case, which involved careful uterine sounding and tandem placement under general anesthesia using transrectal and transabdominal ultrasound guidance, and the patient’s completion of three high-dose-rate ICBT sessions with favorable outcomes, is a testament to the expertise and dedication of the medical professionals involved. This case underscores the importance of their specialized skills, image-guided techniques, and meticulous planning in overcoming anatomical barriers and ensuring effective BT delivery in complex cervical cancer cases.