Primary malignant lymphoma of the uterine cervix shows favorable response to neoadjuvant chemotherapy

Primary malignant lymphoma localized in the uterine cervix is a rare condition for which radiation therapy, surgery, or chemotherapy either alone or in combination have been the mainstay of treatment. The effectiveness of neoadjuvant chemotherapy for this condition, however, has not been evaluated. We experienced one case of primary malignant lymphoma of the uterine cervix, stage IIa according to FIGO, and I_EA according to the Ann Arbor staging system for extranodal lymphomas, which was treated with neoadjuvant chemotherapy and surgery. The patient first underwent neoadjuvant chemotherapy consisting of cyclophosphamide, vinblastine, epirubicin, bleomycin, procarbazin, and oncovin (COP-BLAM) to reduce the size of the tumor. This was followed by an extended total hysterectomy, left salpingo-oophorectomy, and bilateral pelvic lymph node dissection. Neoadjuvant chemotherapy given before surgery resulted in a remarkable reduction in the tumor size which made the subsequent surgery technically easy. In addition, it is possible that intraoperative micrometastasis of the tumor cells could be better prevented. The patient received additional chemotherapy with COP-BLAM schedules postoperatively. No evidence of recurrent lymphoma has been observed in 2 years after the treatment. Neoadjuvant chemotherapy may be an effective treatment modality for primary malignant lymphoma of the uterine cervix.