First-Trimester Radical Hysterectomy for Bulky Cervical Cancer: A Case Report on Oncologic and Reproductive Considerations

The management of cervical cancer during the first trimester of pregnancy requires a multidisciplinary approach that considers medical, psychological, and social factors. This report details the case of a patient diagnosed preoperatively with bulky early-stage cervical cancer at nine weeks of gestation, during an evaluation initially intended for pregnancy termination. While definitive chemoradiotherapy is the standard treatment for early-stage bulky cervical tumors, the treatment strategy, in this case, was influenced by the patient's decision to terminate the pregnancy without delay. A radical hysterectomy with pelvic lymphadenectomy was successfully performed at 10 weeks of gestation. The patient experienced an uneventful postoperative recovery and was subsequently advised to undergo adjuvant chemoradiotherapy. This case underscores the importance of an individualized management plan that prioritizes maternal health while respecting reproductive rights and patient autonomy.