• Cervical Intraepithelial Neoplasia (CIN)

    by  • 28/05/2013 • Gynecologic Cancer

     

    1. RF: HPV 16 and 18, lower socioeconomic status, multiple sexual partners.
    2. P/c: post-coital bleeding in younger female (median age 52), later = menorrhagia, flank/leg pain.
    3. Prevention and diagnosis: regular pap smears (reduces womans risk of death by CIN by 90%)
    4. Pathology:
      1. 10 75-80% = squamous cell carcinoma
      2. 11 20-25% = adenocarcinomas (more difficult to detect)
      3. 12 travels via lymphatic and haemotogenous spread
    5. Staging: clinically staged = I – IV

     

    1. Tx: depends on stage. Worse stage = more aggressive treatment.
    2. Cone biopsy or simple hysterectomy
    3. Radical hysterectomy
    4. Primary chemoradiation therapy
    5. Palliative CT and directed RT
    6.  
    1. Palliation = cisplatin and topotecan 
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