Re: CIS
From: R. Daniel Braun (rd.braun@gmail.com)
Wed Sep 26 09:17:37 2007
1st Case re colpo in 6-12 months
2nd case offer hyst, if declined, re colpo in 6-12 months.
At least 2 good studies have shown that positivity or negativity of margins
is of NO significance.
Dan
On 9/26/07, Raymond Stephen <stephen.raymond@dhhs.tas.gov.au> 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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--
R. Daniel Braun, MD FACOG(L) CMT
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
R. Daniel Braun
"Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
