Background: Cryotherapy is a method of treating low and high-grade lesions of the cervix as well as condylomas. Its success rate in LGSIL is 78%–88%, in HGSIL is 84%, and in condyloma is 50%. The risk of progression from mild to severe lesions is 1% within a year, while the risk of progression from moderate to severe lesions is 16% over 2 years and 25% over 5 years. Objective: The aim of this case report was to present progression of lesions and complications which are extremely rare within the very short period of 3 months; however, if they occur, there should be extremely dangerous factors that cause it. Case presentation: A 30-year-old woman with proper anamnesis for 5 years underwent a preventive gynecological examination. Pap test revealed low-grade squamous intraepithelial lesion (CIN I) and infection with high-risk types of human papillomavirus. Colposcopy revealed pathological acetowhite (AW) epithelium over the anterior lip of the cervical canal. Cryotherapy using liquid nitrogen was performed. At the third follow-up at 88 days, colposcopy revealed 2 pathological lesions including coarse AW epithelium (flat condyloma) on the anterior lip and AW epithelium at the 9 o’clock position at the entrance of the cervical canal. Electrosurgical excision procedure (LOOP) and cervical canal curettage were performed. The histopathological findings indicated condyloma lata high-grade squamous intraepithelial lesion CIN III multifocalis epithelii superficialis et glandularis cervix uteri. The lesion was removed until healthy tissue was reached. After 3 months, the colposcopy findings and control Pap test results were normal. Follow-up was recommended every 3 months due to the previous medical history. Conclusion: The intention of the authors is to draw attention to the fact that it is crucial to continuously monitor a patient with HPV types with high oncogenic potential, which can reactivate anytime and lead to adverse effects such as invasive cervical cancer.
Key words: cervical intraepithelial lesion, HPV 31, 33, cryotherapy, lesion progression
|
