The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Para-Aortic Lymphadenectomy Associated with Excision of Liver Lesions in Advanced-Stage Cervical Cancer – A Case Report


Cervical cancer represents a major health problem, ranking worldwide as the second most frequent malignancy in women (1,2). Although screening tests for cervical cancer are widely utilized, there is still a large number of patients who are diagnosed in an advanced stage of the disease (3). The main patterns of tumoral spread involve mainly parametria, upper vagina, uterus and pelvic lymph nodes (4,5). The incidence of positive lymph nodes increases proportionally with FIGO stage: pelvic lymph node metastases range between 12% in stage Ib up to 43% in stage IIb (4). Metastases to the aortic lymph nodes are secondary to the pelvic ones, the risk of positive para-aortic lymph nodes rising up to 30 %
on the other hand, skip metastases to aortic nodes represents a very rare condition (6-10). Extended para-aortic lymph node dissection provides an appropriate debulking surgery, allows an adequate histological evaluation and disease staging and offers important information in order to plan the extension of postoperative radiation field (7-15).