Carcinoma In Situ with Pelvic Cystic Formation in Early Cervical Cancer After Hysterectomy and Long-Term Treatment for Vaginal Intraepithelial Neoplasma

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Journal of Gynecologic Surgery


Background: Microinvasive cervical cancer at International Federation of Gynecology and Obstetrics stage IA1 can be treated with conization or hysterotomy with favorable outcomes. Vaginal intraepithelial neoplasma (VAIN) after hysterectomy for early cervical cancer is sometimes encountered; however, carcinoma in situ (CIS) resulting from VAIN with pelvic cystic formation is extremely rare.

Case: CIS with pelvic cystic formation occurred 11.5 years after a hysterectomy was performed to treat microinvasive cervical cancer and long-term treatment for persistent VAIN in a 57-year-old multigravida patient. Laparoscopic tumorectomy and adhesiolysis were performed.

Results: Pathology testing showed CIS. This occurrence was considered to be derived from persistent human papilloma virus infection caused by VAIN. Concurrent chemoradiation was performed, and the patient currently has no evidence of disease.

Conclusions: CIN or microinvasive cancer can develop subsequent to VAIN even after hysterectomy and can result in progression to cancer. Careful follow-up is the key to early detection of secondary disease.

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