Re: CIS
From: Efrain Ramirez (eramirezt@coqui.net)
Wed Sep 26 16:33:19 2007
Agree
Ef
>At Wed, 26 Sep 2007, Raymond Stephen wrote:
>
>First case colp four months after the LEEP with pap;
>Second case vag hyst.
>
>Steve
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry
>E. Siegel, M.D.
>Sent: Wednesday, 26 September 2007 3:26 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Gyn: CIS
>
>Two cases:
>
>23 YO P0 with HGSIL pap, office biopsy CIN II or III (can't remember).
>
>OR LEEP: CIN III, no invasion, positive endocervical margin. A nice
>specimen was obtained with a 20 X 15 mm loop.
>
>Would you:
>
>1. Re-LEEP after 6 weeks?
>2. Reassess in the future (3 months)? If so, how, i.e.
> a. Pap and colpo
> b. Pap and colpo and ECC regardless of findings
> c. Other
>
>33 YO P2002, S/P TL, with HGSIL pap, office biopsy CIN III/can't rule
>out invasion.
>
>OR LEEP--large transition zone, two passes, one central and one superior
>with 20 X 15 loop to encompass entire non-staining zone.
>
>Pathology: postive endocervical and ectocervical margins, no invasion,
>glandular involvement.
>
>What would you do here?
>
>1. Re-LEEP after 6 weeks
>2. Reassess in the future (3 months)? If so, how, i.e.
> a. Pap and colpo
> b. Pap and colpo and ECC regardless of findings
> c. Other
>3. TVH?
>
>Garry
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
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