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Re: Abnormal smear post radiotx for Ca CervixFrom: Braun, R. Daniel (rbraun@iupui.edu)Fri Oct 1 11:04:06 1999
3-4 days of estrogen cream to the vagina, may well cause the vagina to open up and allow an adequate evaluation. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN 46202 OBGYN.net International Representative for United States -----Original Message----- From: mstmy@tm.net.my [mailto:mstmy@tm.net.my] Sent: Friday, October 01, 1999 9:43 AM To: Multiple recipients of list OB-GYN-L Subject: Abnormal smear post radiotx for Ca Cervix I have a 61 years old patient who was diagnosed with squamous cell carcinoma of the cervix stage 1b bulky and was treated with radiotherapy in 1997. She remained well on follow up and asymptomatic.Routine follow up pap smear currently was reported as "Atrophic smear showing marked post radiation changes with a few groups of rather degenerate malignant cells, highly suspicious of recurrence." On examination the vaginal wall are adherent and plastered together anteriorly and posteriorly.The cervix can`t be visualised at all. There was however no obvious growth. My Question is what is the next course of action in confirming the suspicion of recurrence? 1) Will a colposcopy be adequate in confirming or refuting the diagnosis? 2)Or instead will a examination under anaesthesia be better to break down the adhesions and attempt made to examine the cervix and if necessary a biopsy performed? 3)What is the role of CT scan in the diagnosis of recurrences? THANK YOU!
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