We report a case of a 42-year-old gravida 3, para 4 woman from Puerto Rico with a history of cervical cancer who presented with dizziness, lethargy, and three days of bright red blood per rectum. Imaging evaluation showed a retroperitoneal lymph node mass with secondary metastasis to the duodenum. After she was stabilized with multiple blood transfusions and to mitigate her ongoing bleeding, she was transferred to a tertiary care hospital for possible embolization by interventional radiologists. However, she was deemed a poor candidate for an interventional procedure and decided to ultimately go home on hospice care. This case highlights the rarity of duodenal metastasis presenting as gastrointestinal bleeding due to cervical squamous cell cancer and further reinforces the need for human papillomavirus vaccination and cervical cancer screening. This case study also illustrates that even though cervical cancer rates are low in the United States, it is still deadly in many countries across the globe. As people continue to travel and migrate across borders, the risk of being lost to follow-up is on the rise.
Keywords: cervical cancer screening; hpv infection; massive lower gi bleeding; pap; radiation and clinical oncology.
Copyright © 2021, Patel et al.