Stephanie M. is a 48-year-old Caucasian mother of 2 children who works as a dental hygienist.
She presented to her PCP in May 2012 with vaginal discharge and pain during intercourse. Prior medical history was notable for smoking (quit 3 years ago) and well-controlled hypertension. Patient had completed only sporadic cervical screening for the past 10 years.
Subsequent Pap smear showed the presence of squamous intraepithelial lesions and HPV-16 positivity
She was referred to oncologist for further evaluation. Ultrasound and colposcopy showed the presence of a 3.0-cm lesion in cervix with extension into the vagina. Patient was diagnosed with squamous cell carcinoma FIGO stage 1B1
Patient underwent radical hysterectomy with pelvic lymphadenectomy, with 3 positive pelvic nodes
She received pelvic radiotherapy with concurrent weekly cisplatin
Patient remained disease free for approximately 2 years
In September 2014, she presented with worsening abdominal pain and fatigue. CT scan showed diffuse pelvic and aortic adenopathy consistent with disease recurrence. Her renal and hepatic function were adequate.
Patient received treatment with cisplatin/paclitaxel for metastatic disease
After 3 cycles, patient presents with worsening pain and CT evidence of disease progression