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Case 27 - A 39-Year-Old P4 Woman with Recurrent HSIL after LEEP

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
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Summary

A 39-year-old para 4 cis-woman presents with a history of an office loop electroexcision procedure (LEEP) one year ago. She was told that they “got everything” during her LEEP. At her one-year follow-up appointment, her cervical cytology and human papillomavirus (HPV) testing were abnormal. She reports that a hysterectomy was recommended for recurrent dysplasia. She desires future fertility. She presents for a second opinion as she did not feel heard at her last doctor’s visit. She reports she is otherwise doing well. She is sexually active with male and female partners and uses condoms regularly. Menses are five days long and occur monthly. Her flow is heavy, but this does not bother her. She is a former smoker, with a 10-year pack history, and uses marijuana regularly. She has no other significant past surgical history. She is currently taking cetirizine and is allergic to sulfa antibiotics.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 78 - 81
Publisher: Cambridge University Press
Print publication year: 2021

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References

Perkins, RB, Guido, RS, Castle, PE, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis 2020; 24: 102–31.Google ScholarPubMed
Tucker Edmonds, B. Shared decision-making and decision support: their role in obstetrics and gynecology. Curr Opin Obstet Gynecol 2014; 26: 523–30.CrossRefGoogle ScholarPubMed
Swift, BE, Wang, L, Jembere, N, et al. Risk of recurrence after treatment for cervical intraepithelial neoplasia 3 and adenocarcinoma in situ of the cervix: recurrence of CIN 3 and AIS of cervix. J Low Genit Tract Dis 2020; 24: 252–8.CrossRefGoogle ScholarPubMed
Kyrgiou, M, Athanasiou, A, Paraskevaidi, M, et al. Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth: systematic review and meta-analysis. BMJ 2016; 354: i3633.CrossRefGoogle ScholarPubMed
Leung, Y, Spilsbury, C, Stewart, CJR, et al. Comparison of cold knife cone biopsy and loop electrosurgical excision procedure in the management of cervical adenocarcinoma in situ: what is the gold standard? Gynecol Oncol 2015; 137: 258–63.Google Scholar
Latig, NA, Neubauer, NL, Helenowski, I, Lurain, JL. Management of adenocarcinoma in situ of the uterine cervix: a Comparison of loop electrosurgical excision procedure and cold knife conization. J Lower Genit Tract Dis 2015; 19: 97102.Google Scholar
Kim, YT, Yoon, BS, Kim, SH, et al. The influence of time intervals between loop electrosurgical excision and subsequent hysterectomy on the morbidity of patients with cervical neoplasia. Gynecol Oncol 2005; 96: 500–3.Google Scholar
Sullivan, SA, Clark, LH, Staley, AS, et al. Association between timing of cervical excision procedure to minimally invasive hysterectomy and surgical complications. Gynecol Oncol 2017; 144: 294–8.CrossRefGoogle ScholarPubMed
Di Spiezio Sardo, A, Giampaolino, P, Manzi, A, et al. The invisible external cervical os. Tips and tricks to overcome this challenge during in-office hysteroscopy. J Minim Invasive Gynecol 2021; 28: 172–3.CrossRefGoogle ScholarPubMed
Schockaert, S, Poppe, W, Arbyn, M, Verguts, T, Verguts, J. Incidence of vaginal intraepithelial neoplasia after hysterectomy for cervical intraepithelial neoplasia: a retrospective study. Am J Obstet Gynecol 2008; 2: 113.e15.CrossRefGoogle Scholar

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