# Unilateral cervical carcinoma in a septate uterus with double cervix: A case report and literature review

## TL;DR

A rare case of cervical cancer in a woman with a duplicated cervix shows how unusual anatomy can complicate diagnosis and treatment.

## Contribution

This case report adds to the limited literature on cervical cancer in patients with Müllerian anomalies and emphasizes the need for individualized care.

## Key findings

- Unilateral cervical cancer can develop in patients with cervical duplication and a longitudinal vaginal septum.
- Routine cytologic screening may be compromised in patients with altered anatomy.
- Multimodal treatment can achieve long-term disease control in such rare cases.

## Abstract

•Unilateral cervical carcinoma can occur in patients with cervical duplication.•Cervical duplication may compromise routine cytologic screening.•Altered anatomy poses significant diagnostic and therapeutic challenges.•Individualized surgical planning is essential in Müllerian anomalies.•Long-term disease control is achievable with multimodal treatment.

Unilateral cervical carcinoma can occur in patients with cervical duplication.

Cervical duplication may compromise routine cytologic screening.

Altered anatomy poses significant diagnostic and therapeutic challenges.

Individualized surgical planning is essential in Müllerian anomalies.

Long-term disease control is achievable with multimodal treatment.

The exact incidence of cervical cancer occurring in patients with Müllerian anomalies is unknown as both conditions are relatively rare and the literature is compromised principally of individual case reports or small series. Despite the rarity of this coexistence, the literature consistently highlights the significant diagnostic and therapeutic challenges it presents. This is particularly true when cervical duplication is present as the altered anatomy can hinder adequate cytologic sampling and delay the detection of malignant lesions.

We report a case of unilateral invasive endocervical adenocarcinoma in a 43-year-old patient with complete septate uterus and longitudinal vaginal septum. The tumor was confined to the left cervix, staged as FIGO IB2 and underwent a type C1 radical hysterectomy with bilateral salpingo-oophorectomy and pelvic and para-aortic lymphadenectomy. Following the histologic confirmation of a well-differentiated adenocarcinoma with lymphovascular invasion and pelvic nodal metastasis the patient underwent chemoradiation and remains disease-free at five years.

This case highlights how cervical duplication, particularly in the presence of a longitudinal vaginal septum may compromise routine screening and underscores the importance of careful anatomic assessment to ensure accurate diagnosis and individualized management in patients with uncommon Müllerian variants.