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Management of Stage IIA2 Cervical Cancer in the Third Trimester: A Case Report and Literature Review

Received: 4 January 2026     Accepted: 15 January 2026     Published: 30 January 2026
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Abstract

Background: Cervical cancer remains one of the most frequently diagnosed gynecological malignancies during pregnancy, presenting a complex clinical dilemma when detected in the second trimester. The management of Stage IIA2 disease, defined by a bulky tumor size of ≥ 4cm without parametrial invasion, is particularly challenging. Standard interventions such as concurrent chemoradiation or immediate radical hysterectomy are incompatible with the preservation of the fetus. Consequently, Neoadjuvant Chemotherapy (NACT) has emerged as a therapeutic strategy to arrest tumor progression and delay delivery until fetal maturity is achieved. Case Presentation: We report the case of a 38-year-old multiparous female (G3P2) who was diagnosed with Stage IIA2 cervical cancer at 25 weeks of gestation. Following a multidisciplinary consultation, the patient was treated with NACT using a Paclitaxel and Carboplatin regimen to control the disease while allowing the fetus to mature. The patient completed four cycles of chemotherapy and was admitted to the obstetrics department at 37 weeks and 1 day of gestation. Pre-operative Magnetic Resonance Imaging (MRI) revealed a residual cervical mass measuring 3.1 x 4.1 x 2.8cm with invasion extending to the upper third of the vagina. Crucially, imaging confirmed the absence of parametrial invasion or pelvic lymphadenopathy. An elective Cesarean section was performed. The procedure resulted in the delivery of a healthy male neonate weighing 2700 grams, with Apgar scores of 8 at 1 minute and 9 at 5 minutes. The maternal postoperative course was uneventful, and the patient was subsequently transferred for definitive oncological management. Conclusion: This case illustrates that the administration of NACT is a viable and effective management strategy for Stage IIA2 cervical cancer diagnosed during the second trimester. This approach facilitates the prolongation of pregnancy to term, thereby minimizing neonatal morbidity associated with preterm birth, without compromising maternal oncological outcomes.

Published in International Journal of Medical Case Reports (Volume 5, Issue 1)
DOI 10.11648/j.ijmcr.20260501.11
Page(s) 1-5
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Cervical Cancer, Pregnancy, Stage IIA2, Neoadjuvant Chemotherapy, Cesarean Section

References
[1] Korenaga TRK, Tewari KS. Gynecologic cancer in pregnancy. Gynecol Oncol. 2020; 157(3): 799-809.
[2] Le Guévelou J, Selleret L, Laas E, Lecuru F, Kissel M. Cervical Cancer Associated with Pregnancy: Current Challenges and Future Strategies. Cancers. 2024; 16(7): 1341.
[3] Wen T, Fish MG, Friedman AM. Trends and outcomes associated with cancer diagnoses during delivery hospitalizations. Semin Perinatol. 2025; 49(2): 152046.
[4] Koh WJ, Greer BE, Abu-Rustum NR, et al. Cervical Cancer. J Natl Compr Canc Netw. 2013; 11(3): 320-343.
[5] Park KJ, Roma A, Singh N, et al. Tumor Staging of Endocervical Adenocarcinoma: Recommendations From the International Society of Gynecological Pathologists. Int J Gynecol Pathol. 2021; 40 Supplement 1): S92-S101.
[6] Dai YF, Xu M, Zhong LY, et al. Prognostic significance of solitary lymph node metastasis in patients with stages IA2 to IIA cervical carcinoma. J Int Med Res. 2018; 46(10): 4082-4091.
[7] Mruzek H, Kacperczyk-Bartnik J, Dańska-Bidzińska A, Ciebiera M, Grabowska-Derlatka L, Derlatka P. Early-Stage and Locally Advanced Cervical Cancer during Pregnancy: Clinical Presentation, Diagnosis and Treatment. Medicina (Mex). 2024; 60(10): 1700.
[8] Qiu J, Sun S, Liu Q, Fu J, Huang Y, Hua K. A comparison of concurrent chemoradiotherapy and radical surgery in patients with specific locally advanced cervical cancer (stage IB3, IIA2, IIICr): trial protocol for a randomized controlled study (C-CRAL trial). J Gynecol Oncol. 2023; 34(5): e64.
[9] LeJeune C, Mora-Soto N, Storgaard L, Pareja R, Amant F. Cervical cancer in pregnancy. Semin Perinatol. 2025; 49(2): 152038.
[10] Ismail N, Abdelaziz AH. Cervical Cancer During Pregnancy: A Comprehensive Review of Diagnostic and Treatment Approaches. Int J Sci Adv. 2025; 6(1).
[11] Triarico S, Rivetti S, Capozza MA, et al. Transplacental Passage and Fetal Effects of Antineoplastic Treatment during Pregnancy. Cancers. 2022; 14(13): 3103.
[12] Song Y, Liu Y, Lin M, Sheng B, Zhu X. Efficacy of neoadjuvant platinum-based chemotherapy during the second and third trimester of pregnancy in women with cervical cancer: an updated systematic review and meta-analysis. Drug Des Devel Ther. 2018; Volume 13: 79-102.
[13] Fruscio R, Villa A, Chiari S, +et al. Delivery delay with neoadjuvant chemotherapy for cervical cancer patients during pregnancy: A series of nine cases and literature review. Gynecol Oncol. 2012; 126(2): 192-197.
[14] Zeng S, Li X, Xiao S, et al. Prognostic evaluation and treatment strategies for cervical cancer in pregnancy: a systematic review and meta-analysis. BMC Cancer. 2025; 25(1): 502.
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  • APA Style

    Ho, T., Nguyen, Y., Lam, H. (2026). Management of Stage IIA2 Cervical Cancer in the Third Trimester: A Case Report and Literature Review. International Journal of Medical Case Reports, 5(1), 1-5. https://doi.org/10.11648/j.ijmcr.20260501.11

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    ACS Style

    Ho, T.; Nguyen, Y.; Lam, H. Management of Stage IIA2 Cervical Cancer in the Third Trimester: A Case Report and Literature Review. Int. J. Med. Case Rep. 2026, 5(1), 1-5. doi: 10.11648/j.ijmcr.20260501.11

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    AMA Style

    Ho T, Nguyen Y, Lam H. Management of Stage IIA2 Cervical Cancer in the Third Trimester: A Case Report and Literature Review. Int J Med Case Rep. 2026;5(1):1-5. doi: 10.11648/j.ijmcr.20260501.11

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  • @article{10.11648/j.ijmcr.20260501.11,
      author = {Tuan Ho and Yen Nguyen and Hoai-Thanh Lam},
      title = {Management of Stage IIA2 Cervical Cancer in the Third Trimester: A Case Report and Literature Review},
      journal = {International Journal of Medical Case Reports},
      volume = {5},
      number = {1},
      pages = {1-5},
      doi = {10.11648/j.ijmcr.20260501.11},
      url = {https://doi.org/10.11648/j.ijmcr.20260501.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmcr.20260501.11},
      abstract = {Background: Cervical cancer remains one of the most frequently diagnosed gynecological malignancies during pregnancy, presenting a complex clinical dilemma when detected in the second trimester. The management of Stage IIA2 disease, defined by a bulky tumor size of ≥ 4cm without parametrial invasion, is particularly challenging. Standard interventions such as concurrent chemoradiation or immediate radical hysterectomy are incompatible with the preservation of the fetus. Consequently, Neoadjuvant Chemotherapy (NACT) has emerged as a therapeutic strategy to arrest tumor progression and delay delivery until fetal maturity is achieved. Case Presentation: We report the case of a 38-year-old multiparous female (G3P2) who was diagnosed with Stage IIA2 cervical cancer at 25 weeks of gestation. Following a multidisciplinary consultation, the patient was treated with NACT using a Paclitaxel and Carboplatin regimen to control the disease while allowing the fetus to mature. The patient completed four cycles of chemotherapy and was admitted to the obstetrics department at 37 weeks and 1 day of gestation. Pre-operative Magnetic Resonance Imaging (MRI) revealed a residual cervical mass measuring 3.1 x 4.1 x 2.8cm with invasion extending to the upper third of the vagina. Crucially, imaging confirmed the absence of parametrial invasion or pelvic lymphadenopathy. An elective Cesarean section was performed. The procedure resulted in the delivery of a healthy male neonate weighing 2700 grams, with Apgar scores of 8 at 1 minute and 9 at 5 minutes. The maternal postoperative course was uneventful, and the patient was subsequently transferred for definitive oncological management. Conclusion: This case illustrates that the administration of NACT is a viable and effective management strategy for Stage IIA2 cervical cancer diagnosed during the second trimester. This approach facilitates the prolongation of pregnancy to term, thereby minimizing neonatal morbidity associated with preterm birth, without compromising maternal oncological outcomes.},
     year = {2026}
    }
    

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    AU  - Tuan Ho
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    AB  - Background: Cervical cancer remains one of the most frequently diagnosed gynecological malignancies during pregnancy, presenting a complex clinical dilemma when detected in the second trimester. The management of Stage IIA2 disease, defined by a bulky tumor size of ≥ 4cm without parametrial invasion, is particularly challenging. Standard interventions such as concurrent chemoradiation or immediate radical hysterectomy are incompatible with the preservation of the fetus. Consequently, Neoadjuvant Chemotherapy (NACT) has emerged as a therapeutic strategy to arrest tumor progression and delay delivery until fetal maturity is achieved. Case Presentation: We report the case of a 38-year-old multiparous female (G3P2) who was diagnosed with Stage IIA2 cervical cancer at 25 weeks of gestation. Following a multidisciplinary consultation, the patient was treated with NACT using a Paclitaxel and Carboplatin regimen to control the disease while allowing the fetus to mature. The patient completed four cycles of chemotherapy and was admitted to the obstetrics department at 37 weeks and 1 day of gestation. Pre-operative Magnetic Resonance Imaging (MRI) revealed a residual cervical mass measuring 3.1 x 4.1 x 2.8cm with invasion extending to the upper third of the vagina. Crucially, imaging confirmed the absence of parametrial invasion or pelvic lymphadenopathy. An elective Cesarean section was performed. The procedure resulted in the delivery of a healthy male neonate weighing 2700 grams, with Apgar scores of 8 at 1 minute and 9 at 5 minutes. The maternal postoperative course was uneventful, and the patient was subsequently transferred for definitive oncological management. Conclusion: This case illustrates that the administration of NACT is a viable and effective management strategy for Stage IIA2 cervical cancer diagnosed during the second trimester. This approach facilitates the prolongation of pregnancy to term, thereby minimizing neonatal morbidity associated with preterm birth, without compromising maternal oncological outcomes.
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