Cervical cancer is an aggressive gynecological malignancy which can develop local invasion of the surrounding organs. In cases presenting locally advanced disease, the association of neoadjuvant chemo-irradiation might reduce the local invasion and might transform the patient into a candidate for a conservative surgical procedure. However, there are also patients who refuse any association of neoadjuvant treatment; we present the case of a 52-year-old patient diagnosed with a locally invasive cervical tumor involving both ureteral ostia who formally refused any neoadjuvant oncological treatment and urostomy. Total radical hysterectomy with bilateral adnexectomy with partial cystectomy and distal bilateral ureterectomy was performed. The two ureters were re-implanted in the remnant urinary bladder.
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