Brain metastases from cervical cancer are exceedingly rare, with an incidence of 0.4% to 2.3%. Poorly differentiated histologic subtypes, particularly those with lymphovascular space invasion (LVSI) and parametrial involvement, may have a higher propensity for hematogenous spread. Current surveillance protocols do not routinely include brain imaging, potentially leading to delayed diagnosis in patients with early metastases. This case highlights an aggressive presentation of poorly differentiated squamous cell carcinoma (SCC) of the cervix with rapid brain metastases post-treatment, emphasizing the need for revised follow-up and therapeutic strategies. A 46-year-old woman presented with postcoital bleeding and was diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIA1 poorly differentiated non-keratinizing SCC of the cervix. She underwent radical hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy, followed by adjuvant chemoradiotherapy. Despite initial disease control, she developed progressive neurological symptoms five months post-treatment. Brain imaging revealed multiple intracranial metastases, confirmed histologically as metastatic SCC. She un-derwent craniotomy and tumor resection, followed by palliative care due to extensive systemic involvement, including lung metastases. This case highlights the limitations of current surveillance and treatment paradigms in high-risk cervical cancer patients. Earlier imaging and innovative systemic therapies with improved blood-brain barrier penetration may enhance patient outcomes. Future research should focus on refining post-treatment follow-up protocols and integrating novel therapeutic ap-proaches for metastatic cervical cancer.

Background and Purpose: Concurrent chemoradiotherapy (CCRT) remains the standard of care for locally advanced cervical cancer, yet recurrence and treatment-related toxicity continue to limit outcomes. Neoadjuvant chemotherapy using a Paclitaxel-Carboplatin regimen followed by CCRT (NACT-CCRT) been proposed to improve therapeutic response while minimizing systemic toxicity. This study aimed to compare the efficacy and safety of NACT-CCRT versus CCRT alone in patients with locally advanced (FIGO IIA–IIIC) and metastatic (stage IVA) cervical cancer. Patients and Methods: Prospective cohort study was conducted at Hasan Sadikin General Hospital, Bandung, between July 2024 and September 2025. Sixty-five eligible patients were enrolled using convenience sampling, comprising 32 in the NACT+CCRT group and 33 in the CCRT group. Treatment response was assessed according to RECIST 1.1 criteria, and tumour size reduction was measured using pelvic MRI before and after therapy. Statistical analysis included independent t-tests, Chi-square tests, and Repeated Measures ANOVA, with significance set at p< 0.05. Results: Patients receiving NACT-CCRT achieved higher complete and overall response rates (100%) compared to those treated with CCRT alone. Tumour reduction exceeding 75% was observed in both groups, with the NACT+CCRT group show lower mortality rate. No significant increase in treatment-related toxicity was noted. Conclusion: The combination of Paclitaxel Carboplatin-based neoadjuvant chemotherapy followed by chemoradiation appears to be an effective and well-tolerated approach for selected patients with locally advanced cervical cancer, particularly those with good performance status and large tumours. Nevertheless, larger randomized controlled trials and biomarker-driven studies are needed to validate these findings and identify subgroups that may achieve the most durable clinical benefit.

Gestational Trophoblastic Neoplasia (GTN) involving the cervix is an uncommon and potentially life-threatening condition that poses significant diagnostic and therapeutic challenges. Early recognition and risk-adapted management are essential to achieve optimal outcomes. We report a 36-year-old woman with a prior history of molar pregnancy who presented with abnormal vaginal bleeding and systemic symptoms suggestive of malignancy. Laboratory evaluation revealed markedly elevated serum β-hCG levels, and imaging demonstrated a hypervascular cervical mass. The diagnosis of GTN involving the cervix was established based on clinical, radiologic, and biochemical findings. The patient was managed with EMA-CO chemotherapy (etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine) as per high-risk GTN protocol. She tolerated the regimen well with only mild adverse effects. Serial β-hCG monitoring demonstrated a consistent decline, and complete remission was achieved after 10 cycles of EMA-CO followed by 2 consolidation cycles. Follow-up imaging confirmed the absence of residual or recurrent disease. This case underscores the effectiveness of EMA-CO chemotherapy in achieving complete remission in high-risk GTN involving the cervix. It highlights the importance of early diagnosis, multidisciplinary coordination, and rigorous post-molar surveillance in improving outcomes for patients with this rare presentation.