METASTATIC CERVICAL-CANCER AND PELVIC INFLAMMATORY DISEASE IN AN AIDSPATIENT

The Center for Disease Control (CDC) recently added invasive cervical cancer to its list of surveillance case-defining diseases, and also in cluded cervical dysplasia, carcinoma in situ, and pelvic inflammatory disease (PID) in the classification system. There are several reported cases of cervical cancer in AIDS patients that behaved in an unusuall y aggressive fashion and responded poorly to therapy. In light of the above-reported cases, it may be expected that cervical cancer may mani fest itself in unusual ways in HIV-positive women. A case of aggressiv e cervical cancer in an AIDS patient with PID is reported. She was adm itted with PID and newly diagnosed cervical cancer with recurrent feve r spikes despite adequate antibiotic coverage. An aspiration of a pres umed psoas abscess revealed metastatic squamous cell carcinoma. These data suggest that not only are HIV-infected women at risk for aggressi ve and unusual presentations of cervical cancer, but also that coexist ent pelvic infection may contribute to development and spread of the d isease. Immunosuppression from the virus may increase the incidence an d severity of neoplasia. Data suggest that cervical cancer in HIV-infe cted women is often of advanced stage and responds poorly to treatment . Unique treatment approaches may need to be developed as conventional strategies do not seem to be adequate. More research is required to d etermine what these strategies should be. Lastly, universal HIV screen ing of women with either PID or cervical cancer seems prudent. (C) 199 4 Academic Press, Inc.