Missed Diagnosis of Invasive Cervical Cancer Leads to Fatal Metastasis

ByMichael Talve, CEO


Updated onJune 30, 2017

Missed Diagnosis of Invasive Cervical Cancer Leads to Fatal Metastasis

This case involves a fifty-nine-year-old female patient who presented to her gynecologist complaining of abnormal vaginal bleeding that usually occurred after sexual intercourse. The patient also reported some vaginal discomfort, malodorous discharge, and painful urination. The physician said that her symptoms were likely due to vaginal atrophy and suggested that she use water-based lubricants before intercourse to prevent tearing and the associated bleeding. The patient did not receive a vaginal exam, ultrasound, or any other diagnostic testing during the visit. Four months later, the patient was admitted to the hospital for severe leg edema, pelvic pain, and acute kidney failure. The physician on her case suggested that the triad of symptoms pointed to a possible malignancy, with pelvic wall involvement. Upon further workup, it was revealed that the patient had invasive cervical cancer with distant metastasis, which included positive extra, pelvic lymph nodes that spread to the liver, lung, and bone. Her prognosis was considered to be very poor and she was referred for palliative measures.

Question(s) For Expert Witness

1. What is the accepted workup when a patient presents with abnormal vaginal bleeding?

Expert Witness Response E-006303

inline imageComplete evaluation starts with Papanicolaou (Pap) testing and this patient should have had this performed on her original visit to attempt to discover the cancer, sooner. Positive results should prompt colposcopy and biopsies with further workup of cervical intraepithelial neoplasia (CIN), including excisional procedures. If pathologic evaluation after loop electrosurgical excision or conization suggests invasive cancer with positive margins, the patient should be referred to a gynecologic oncologist. Patients with suspicious or grossly abnormal cervical lesions on physical examination should undergo biopsy regardless of the cytologic findings.

About the author

Michael Talve, CEO

Michael Talve, CEO

Michael Talve stands at the forefront of legal innovation as the CEO and Managing Director of Expert Institute. Under his leadership, the Expert Institute has established itself as a vital player in the legal technology arena, revolutionizing how lawyers connect with world-class experts and access advanced legal technology. Michael's role involves not only steering the company's strategic direction but also ensuring the delivery of unparalleled intelligence and cutting-edge solutions to legal professionals. His work at Expert Institute has been instrumental in enhancing the capabilities of attorneys in case preparation and execution, making a significant impact on the legal industry's approach to expert consultation and technological integration. Michael's vision and execution have positioned the Expert Institute as a key facilitator in the intersection of law and technology.

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