Case Presentation
A 47-year-old woman with 1 pregnancy 1 parity and no relevant medical history, family history, or menstruation history presented to our hospital. The patient was followed up from CIN 1 to 2 at a previous hospital for 8 years. The high-risk HPV test was negative twice. Subsequently, a papillary mass was found in the cervix, and histological examination of the cervix suggested CIN 3 or condyloma. Conization was performed for diagnosis at another hospital. The diagnosis was cervical condyloma with a positive margin.
Subsequently, the patient returned to the previous hospital and was followed up. However, 3 months later, there was recurrence of papillary tumor in the cervix; a biopsy was performed, which led to the diagnosis of condyloma. Cervical laser ablation was performed to treat the tumor. Two months later, the cervical tumor relapsed. Although laser vaporization was performed, the tumor relapsed again after 1 month. Cryotherapy was performed to treat the relapsed tumor, but the cervical tumor relapsed. Since the tumor recurred repeatedly in a short time, pathohistological examination was performed by a pathologist at another hospital, and the possibility of PSCC was indicated; the patient was then referred to our hospital for examination.
Colposcopy revealed a condyloma-like papillary tumor approximately 1.5 cm in diameter (Figure 1a). No abnormalities were observed in other internal examination findings. Transvaginal ultrasonography revealed no abnormal findings in the uterus or ovaries. The results of a cervical biopsy under colposcopy were atypical epithelium, which was difficult to diagnose by biopsy alone. There were no apparent abnormalities in the MRI findings (Figure 1b), CT findings, or tumor markers. Cervical conization was performed to confirm the diagnosis (Figure 1c), and the patient was diagnosed with non-invasive PSCC (Figure 2a, b). Immunohistochemistry analysis showed that p 16 was strongly positive in surgical samples (Figure 2c). A cervical test for high-risk HPV was negative in our hospital. Laparoscopic total hysterectomy and bilateral salpingo-oophorectomy were performed. The patient was discharged with a good postoperative course and was followed up as an outpatient. After surgery for PSCC, a cervical specimen was removed and tested for HPV-DNA, which revealed HPV type 6.