Treatment of precancerous gynecological tumors

Precancers of gynecological tumors^[1]^[2] can be treated either surgically with a curative result, which is the most common procedure, or conservatively.

Surgical treatment[edit | edit source]

Surgical treatment is possibly destructive or ablative. During the destructive procedure, precancerous tissue is destroyed, so it can no longer be examined histologically. Therefore, it is necessary to take a biopsy sample in advance. Destructive methods are rarely used anymore. In the case of ablative, surgical removal of the tissue is performed, which can then be examined histologically.

Vulva: Excision of the lesion or skinning is performed.

Vagina: Among the destructive ones, we can mention laser vaporization, which is no longer used much. Of the ablative methods, laser ablation is used, with a more radical approach, partial or even total colpectomy.

Cervix: Of the ablative methods, conization or cylindrical dissection is performed.^[1] A common method is the LEEP (loop electrosurgery excision procedure), in which the cone of the cervix is cut out with an electrocoagulation loop. Another option is the cold knife method. Rarely, laser ablation is also performed.

Endometrium: Hysterectomy with bilateral adnexectomy is performed. Fertility-preserving treatment is non-surgical (see below).

Non-surgical treatment[edit | edit source]

For precancers of the vulva and vagina, immunomodulatory treatment against HPV with the preparation Imiquimod can be used. In endometrial precancer, progestagen treatment can be used to preserve the uterus and achieve regression of the lesion.

Gallery[edit | edit source]

Physiological appearance of the cervicovaginal junction
LSIL: cells with enlarged nucleus and irregular chromatin
HSIL: smaller tumor cells with an enlarged nucleus and irregular chromatin
Adenocarcinoma: tumor cells filled with intracytoplasmic vacuoles with mucus

Links[edit | edit source]

External links[edit | edit source]

References[edit | edit source]

↑ ^a ^b SLÁMA, Jiří. Prekancerózy rodidel [lecture for subject Gynekologie a porodnictví předstátnicová stáž, specialization Všeobecné lékařství, 1. lékařská fakulta Univerzita Karlova v Praze]. Praha. 13.2.2014.
↑ ROB, Lukáš – MARTAN, Alois – CITTERBART, Karel. Gynekologie. 2. edition. Praha : Galén, 2008. 390 pp. pp. 179-213. ISBN 978-80-7262-501-7.

Categories: Gynecology, Oncology

[Prednaska-doc-Slama-1] SLÁMA, Jiří. Prekancerózy rodidel [lecture for subject Gynekologie a porodnictví předstátnicová stáž, specialization Všeobecné lékařství, 1. lékařská fakulta Univerzita Karlova v Praze]. Praha. 13.2.2014.

[Rob-Martan-2] ROB, Lukáš – MARTAN, Alois – CITTERBART, Karel. Gynekologie. 2. edition. Praha : Galén, 2008. 390 pp. pp. 179-213. ISBN 978-80-7262-501-7.

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