Carcinoma In Situ (Cervix)

Chapter 99 Carcinoma In Situ (Cervix)



INTRODUCTION



Description: Carcinoma in situ of the cervix is characterized by morphologic alteration of the cervical epithelium in which the full thickness of the epithelium is replaced with dysplastic cells (cervical intraepithelial neoplasia [CIN] III). This change is generally associated either spatially or temporally with invasive carcinoma.

Prevalence: Less than 2% of Pap tests.

Predominant Age: Early 30s (peak approximately age 32).

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Unknown, strongly linked to some serotypes of human papillomavirus (HPV; 99.7% of cancers contain high-risk HPV serotypes).

Risk Factors: Infection by HPV, herpes virus, or cytomegalovirus; early sexual activity; multiple sexual partners; cigarette smoking (1.5 times risk); oral contraceptive use (2 to 4 times risk); early childbearing; intrauterine diethylstilbestrol exposure; immunosuppression.


CLINICAL CHARACTERISTICS



Signs and Symptoms



• Asymptomatic

• Abnormal cervical cytology

• Abnormal colposcopy


DIAGNOSTIC APPROACH



Differential Diagnosis



• Moderate dysplasia

• Microinvasive and invasive carcinoma


Associated Conditions: HPV infection, condyloma acuminata.


Workup and Evaluation



Laboratory: No evaluation indicated.

Imaging: No imaging indicated.

Special Tests: Colposcopy, colposcopically directed biopsy, and endocervical curettage.

Diagnostic Procedures: Cervical cytologic examination, colposcopy, and biopsy.

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Carcinoma In Situ (Cervix)

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