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Re: Abnormal smear post radiotx for Ca Cervix From: A.C. Evans (ahcevans@execpc.com) Sat Oct 2 11:59:19 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dirk Classen, M.D.: "hormonal tratment in benign hepatic tumour" Previous message: A.C. Evans: "Re: 81 y/o with a simple cyst" On Fri, 1 Oct 1999 09:42:52 -0500, mstmy@tm.net.my (John Teo) wrote: >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. Where was the Pap from, then? >My Question is what is the next course of action in confirming the >suspicion of recurrence? Send to a gyn oncologist. >1) Will a colposcopy be adequate in confirming or refuting the >diagnosis? No. >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? Yes. Needs Tru-Cut needle biopsies and perhaps laparoscopy. >3)What is the role of CT scan in the diagnosis of recurrences? Not good, but it is a reasonable test to evaluate extent of disease. That is, to evaluate for hydroureter or adenopathy or liver mets. I also get MRI if planning an exenteration to look for sidewall invasion. She needs prompt evaluation because she may be a candidate for exenterative (curative) surgery. Don't delay. Craig Evans, MD, PhD Director, Gynecologic Oncology Vince Lombardi Cancer Clinic Milwaukee, WI Next message: Dirk Classen, M.D.: "hormonal tratment in benign hepatic tumour" Previous message: A.C. Evans: "Re: 81 y/o with a simple cyst"

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