CARCINOMA CERVICAL INVASOR EN UNA MUJER DE 28 AÑOS SIN ANTECEDENTE DOCUMENTADO DE VPH DETECTABLE: REPORTE DE CASO Y REVISIÓN BREVE

Abstract

DOI: https://doi.org/10.46296/yc.v10i19.0991

Abstract

Background: Most invasive cervical cancers are associated with persistent human papillomavirus (HPV) infection; however, cases lacking a documented history of detectable HPV raise diagnostic and interpretive challenges, particularly in young women. Case presentation: A 28-year-old woman with no relevant comorbidities was referred after abnormal cervical cytology and a biopsy consistent with poorly differentiated squamous cell carcinoma. She later developed pelvic pain, progressive vaginal bleeding, and hematuria. Gynecologic examination revealed a bleeding cervical mass measuring approximately 4–5 cm. Pelvic magnetic resonance imaging showed a 40.8 mm eccentric cervical lesion with heterogeneous enhancement and diffusion restriction, without reported pelvic lymphadenopathy. Chest computed tomography showed no metastatic extension. The disease was clinically documented as stage IIB. Definitive treatment consisted of external-beam radiotherapy (50.4 Gy in 28 fractions), six weekly cycles of concurrent cisplatin, and high-dose-rate brachytherapy. Post-treatment cervical sampling showed no invasive carcinoma in the examined fragments, although moderate-to-severe squamous dysplasia persisted. Conclusion: Young age and lack of documented detectable HPV should not delay biopsy of a suspicious cervical lesion. A truly HPV-independent cervical carcinoma requires appropriate virologic and/or immunohistochemical confirmation.

Keywords: cervical cancer; squamous cell carcinoma; human papillomavirus; young woman; chemoradiotherapy; case report.