Successful treatment of massive stage IIIB cervical cancer with a spindle cell component

Rationale: Cervical cancer is one of the most common malignancies in women worldwide. Tumors larger than 10 cm in diameter are rarely encountered, and no standard protocol exists for treating them. This case serves as a reference for managing similarly giant tumors and illustrates how a sequential multimodal strategy can downstage the disease. Patient concerns: A 33-year-old woman presented with a cervical mass of 14 × 13 × 13 cm, 6 months of intermittent vaginal bleeding, and 1 month of progressive fatigue. Diagnoses: Biopsy confirmed stage IIIB cervical squamous cell carcinoma (International Federation of Gynecology and Obstetrics 2021) with a partial spindle cell component. Interventions: Because of the tumor size, neoadjuvant chemotherapy was given first to reduce tumor burden; concurrent chemoradiotherapy and bevacizumab were then administered. Outcomes: Complete remission was achieved after the planned treatment sequence. Imaging at 6 months of follow-up showed no recurrence or metastasis. Lessons: Individualized sequential multimodal therapy can produce complete remission in massive cervical squamous cell carcinoma. Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy plus bevacizumab may be a curative option for selected patients with bulky stage IIIB disease.