Abstract:

Cervical squamous cell carcinoma is the most common gynecological malignancy, and platinum-based chemotherapy remains the cornerstone of its treatment. However, it may cause rare but life-threatening complications such as the central nervous system and electrolyte disturbances. We report a case of a 63-year-old patient with locally advanced cervical squamous cell carcinoma (FIGO stage Ⅲ C1r) who developed sudden loss of consciousness, generalized tonic-clonic seizures, and foaming at the mouth within 48 hours after receiving neoadjuvant chemotherapy with paclitaxel plus cisplatin. Emergency blood tests revealed a serum sodium level of 114 mmol/L, leading to a diagnosis of severe cisplatin-associated with secondary status epilepticus. After management with fluid restriction, sodium supplementation, and levetiracetam for seizure control, serum sodium gradually increased to 120 mmol/L without further epileptic seizure. Unfortunately, the patient was eventually discharged against medical advice due to family refusal of further treatment. This case highlights the necessity of close monitoring of electrolytes and neurological function after cisplatin chemotherapy. Early recognition of syndrome of inappropriate secretion of antidiuretic hormone or renal salt wasting syndrome, along with prompt intervention, is crucial to prevent fatal outcomes.

Key words: Uterine cervical neoplasms, Carcinoma, squamous cell, Cisplatin, Hyponatremia, Neoadjuvant chemotherapy, Secondary epilepsy