engleski

Microinvasive cervical cancer after pregnancy „Vanished“

Background: Diagnosis of malignant and premalignant cervical lesions during pregnancy is complex due to increased risk for overlooking invasive cervical carcinoma and the need for minimally aggressive approach at the same time due to increased pregnancy related risk of procedure complications. (1, 2). Immunological changes during or after pregnancy are partially responsible for altered response to premalignant cervical lesions and HPV infection which are considered to be precondition for micro invasive cervical cancer.(3) Coploscopy controlled targeted biopsy except physical removal of the lesion presumably has effects which encourage local or systemic immunological response to tissue damage. Case report: Thirty-four year old women in 15 th week of pregnancy during cytological screening, high grade intraepithelial cervical lesion (CIN III) was diagnosed. Following the Rio de Janeiro (4) colposcopy classification, colposcopy showed possible invasive disease with characteristic description of atypical blood vessels. The patient refused proposed cervical biopsy and further regular cytology and colposcopy controls during pregnancy were performed. The patient was delivered at term pregnancy. Six weeks after delivery, colposcopy controlled targeted cervical biopsy was performed. Histology result showed micro invasive cervical cancer which reaches the edges. Conisation was performed and histology result did not find previously described lesion, only inflammatory- fibrous reaction on the place of previously performed biopsy. The results are multiple checked and both histology results are confirmed. Conclusion: We confirmed the importance of colposcopy in diagnostics and therapy of premalignant and malignant cervical intraepithelial lesion. Immunologic changes after pregnancy and artificial damage of the tissue can be additional reason for unexpected vanishing of micro invasive cervical cancer.

colposcopy ; micro invasive cervical cancer ; pregnancy

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