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Two Types of Cervical Carcinoma

Cytologic Findings in Type 2 Cervical Carcinomas: Some Cervical Carcinomas are more Difficult to Prevent with Screening R. Marshall Austin MD,PhD Magee-Womens Hospital of University of Pittsburgh Medical Center. Two Types of Cervical Carcinoma. Type I Cervical Cancers (Slow-Growing).

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Two Types of Cervical Carcinoma

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  1. Cytologic Findings in Type 2 Cervical Carcinomas: Some Cervical Carcinomas are more Difficult to Prevent with ScreeningR. Marshall Austin MD,PhDMagee-Womens Hospital of University of Pittsburgh Medical Center

  2. Two Types of Cervical Carcinoma Type I Cervical Cancers (Slow-Growing) EXTENSIVE CIN3 Limited Superficial Invasive Cancer Type II Cervical Cancers LIMITED, NONDIAGNOSTIC, OR HIDDEN CIN3/AIS Subsurface Invasive Cancer may remain asymptomatic until cervical rupture

  3. Agency for Healthcare Policy and Research Evidence Report/Technology Assessment Number 5 Evaluation of Cervical Cytology (1999)

  4. Cervical Cancer Cases per 100,000 women screened ages 15-85 ( “Evaluation of Cervical Cytology” 1999 )

  5. Case #1: Aggressive Squamous Carcinoma in a Young Woman • 10 yrs before SCC dx: Pap “Benign cellular changes” • 9 yrs before SCC dx: Pap “Inflammatory changes” Class I • 7 yrs before SCC dx: WNL atrophy • 6 yrs before SCC dx: WNL atrophy • 3 yrs before SCC dx: Negative

  6. Pap 14 months before SCC diagnosis

  7. Pap 14 months before SCC diagnosis

  8. Pap 14 months before SCC diagnosis

  9. Pap 14 months before SCC diagnosis

  10. Pap 14 months before SCC diagnosis

  11. Pap 14 months before SCC diagnosis

  12. Cervical Biopsy- Age 26 • Bloody discharge • Beefy red abnormal-appearing cervix, clinically suspicious for cancer

  13. Cervical Biopsy- Age 26

  14. Cervical Biopsy- Age 26

  15. Cervical Biopsy- Age 26

  16. Cervical Biopsy- Age 26

  17. Diagnosis • Stage 1B cervical squamous cell carcinoma diagnosed at age 26, 3 ½ yrs later free of disease Treatment • Hysterectomy • Chemoradiation

  18. Case#1: Issues • Likelihood of symptoms in Stage I cervical carcinoma is only around 15%. • Less cellular abnormal Pap smears are more likely to result in false negative screening test results. • Smaller CIN3 lesions will shed fewer abnormal cells.

  19. Two Types of Cervical Carcinoma Type I Cervical Cancers (Slow-Growing) EXTENSIVE CIN3 Limited Superficial Invasive Cancer Type II Cervical Cancers LIMITED, NONDIAGNOSTIC, OR HIDDEN CIN3/AIS Subsurface Invasive Cancer may remain asymptomatic until cervical rupture

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