Re: sidual dysplasia
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Wed Dec 31 19:16:17 2003
Also agree with #3, but did you say what degree the current pathology
had (you said she had HGSIL years ago).
BTW, and please correct me if I'm wrong:
LGSIL and HGSIL are cytologic diagnoses.
Dysplasia--mild, moderate, severe, or CIS, or CIN I, II, or III- are
pathologic diagnoses.
Is that correct?
Garry
At Wed, 31 Dec 2003, Joanne Bulley, MD wrote:
>
>I agree - #3
>
>I had a patient with CIS and positive margins that the gyn onc
>recommended this approach.
>
>But as has been said - you have to somehow contract with her about
>follow up - and the pursue her when/if she no-shows!
>
>Joanne
>
>At Wed, 31 Dec 2003, Lynn D. Montgomery, M.D. wrote:
>>
>>I agree with Larry, often times you get a resolution of the margins just
>>because of the adjacent treatment. Given her desire to retain
>>fertility, I would elect to follow - now the issue is her previous lack
>>of follow-up and if you are suspicious of her doing the same thing
>>again, then I might be more aggressive...
>>Lynn
>>
>>P.S. Happy New Year Everyone.
>>
>>--
>>Lynn D. Montgomery, M.D.
>>Rocky Mountain Women's Health
>>2835 Fort Missoula Rd., Suite 303
>>Missoula, Montana, 59804
>>406-549-0978
>>fax 406-549-0987
>>e-mail: apgar10@montanadsl.net
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Larry
>>Glazerman
>>Sent: Wednesday, December 31, 2003 10:28 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: residual dysplasia
>>
>>I'd choose #3. Often, removing the bulk of disease will let the immune
>>system resolve the rest.
>>
>>Larry R. Glazerman, MD
>>Ob-Gyn at Trexlertown, PC
>>larry.glazerman@lvh.com
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>Charlie Chambers
>>Sent: Wednesday, December 31, 2003 11:17 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: residual dysplasia
>>
>>Suggestions on F/U regarding this patient sent to me today.
>>
>>Multiparous patient with HGSIL several years ago, and was lost to F/U.
>>Had LEEP done last month at another office with multiple margins (endo
>>and ecto) that are positive. She wants to keep her uterus in order to
>>have more chldren. What would others do?
>>
>>1. another LEEP
>>2. cold knife cone
>>3. recolpo and ECC at 6-8 weeks
>>
>>BTW, I examined her yesterday because of bleeding. The prior LEEP was
>>huge. Looks like one of those "cowboy hat" excisions with a wide loop
>>then a narrow deep loop done.
>>
>>************************************************************************
>>
>>************************************************************************
>>--
>>************************************************************************
>>*
>>************************************************************************
>>Charlie Chambers
>>Hood River, OR
>>cchamber@alumni.rice.edu
>>
>>"No matter where you go...
>> there you are."
>>Dr. Buckaroo Banzai
>>************************************************************************
>>
>>************************************************************************
>>************************************************************************
>>
>--
>Joanne Bulley, MD
>Keene, NH, USA
>
>-----
>Work to create peace everywhere you go and with everything you do.
>-----
>Let us accept truth, even when it surprises us and alters our views.
>-George Sand
>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
