Abstract
A 74-year-old woman who had a past history of two pregnancies and one vaginal delivery and a history of gait disorder and a decline in the activity of daily living (ADL) due to osteoarthritis of the right hip visited a nearby clinic for incontinence. She was referred to our hospital for a cystic mass in the lower abdomen and was diagnosed with cervical cancer stage IIIb accompanied by pyometra in the complete physical examination. Despite disappearance after concurrent chemoradiotherapy (CCRT), pyometra recurred suddenly on post-CCRT day 92 and was accompanied by the hardening of the cervix. Pus was completely drained vaginally on day 92 and 97, but because of the perforation of uterus, the patient underwent emergency laparotomy on day 103. The surgical outcome was satisfactory, and the patient was discharged 7 weeks later. Based on our experience, patients with advanced cervical cancer accompanied by pyometra require careful observation. Especially after recurrence, prognosis may be poor because of the sudden worsening of pyometra and perforation of the uterus. Therefore, in addition to the vaginal drainage of pus, physicians should also proactively perform dilation of the cervical canal, and when this is not possible, it may be necessary to resect the uterus.
