Li H, Mei SS, Mao PY, Wang XY, Yang HD. Hysteroscopic cervical biopsy for women with persistent human papillomavirus infection after loop electrosurgical excision procedure: A case report. World J Clin Cases 2024; 12(21): 4777-4782 [PMID: 39070846 DOI: 10.12998/wjcc.v12.i21.4777]
Corresponding Author of This Article
Hua-Di Yang, MD, Doctor, Department of Gynecology and Obstetrics, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Shangcheng District, Hangzhou 310006, Zhejiang Province, China. rani712@163.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 26, 2024; 12(21): 4777-4782 Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4777
Hysteroscopic cervical biopsy for women with persistent human papillomavirus infection after loop electrosurgical excision procedure: A case report
Hui Li, Shan-Shan Mei, Pei-Yu Mao, Xin-Yan Wang, Hua-Di Yang
Hui Li, Shan-Shan Mei, Pei-Yu Mao, Xin-Yan Wang, Hua-Di Yang, Department of Gynecology and Obstetrics, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang Province, China
Author contributions: Li H was responsible for formal analysis, methodology, writing; Mei SS was responsible for visualization, writing; Mao PY was responsible for data curation, formal analysis, writing; Wang XY was responsible for formal analysis, writing; Yang HD was responsible for methodology, project administration, supervision, writing, review and editing.
Supported by2024 Natural Science Joint Foundation of Zhejiang Province, No. LBY24H040007.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and all accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: We have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua-Di Yang, MD, Doctor, Department of Gynecology and Obstetrics, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Shangcheng District, Hangzhou 310006, Zhejiang Province, China. rani712@163.com
Received: April 8, 2024 Revised: May 11, 2024 Accepted: June 20, 2024 Published online: July 26, 2024 Processing time: 84 Days and 0.5 Hours
Abstract
BACKGROUND
Almost all cases of cervical cancer can be attributed to human papillomavirus (HPV) infection. The loop electrosurgical excision procedure (LEEP) is widely used to treat HPV-mediated disease; thus, cervical cancer is highly preventable. However, LEEP does not necessarily clear HPV rapidly and may affect the accuracy of the results of ThinPrep cytology test (TCT) and cervical biopsy due to the formation of cervical scars.
CASE SUMMARY
A 40-year-old woman underwent LEEP for cervical intraepithelial neoplasia grade 1 approximately 10 years ago. Subsequent standard cervical cancer screening suggested persistent HPV-52 infection, but TCT results were negative. Cervical biopsy under colposcopy was performed thrice over a 10-year period, yielding negative pathology results. She developed abnormal vaginal bleeding after sexual activity, persisting for approximately 1 year, and underwent hysteroscopy in our hospital. Histopathologic evaluation confirmed adenocarcinoma in situ of the uterine cervix.
CONCLUSION
Patients with long-term persistent, high-risk HPV infection and negative pathology results of cervical biopsy after LEEP are at risk of cervical cancer. Hysteroscopic resection of cervical canal tissue is recommended as a supplement to cervical biopsy because it helps define the lesion site and may yield a pathologic diagnosis.
Core Tip: The loop electrosurgical excision procedure (LEEP) is widely used to treat human papillomavirus (HPV)-mediated disease; thus, cervical cancer is highly preventable. However, LEEP does not necessarily clear HPV infection rapidly, and patients with persistent HPV infection after LEEP are at risk of cervical cancer. The formation of cervical scars after LEEP may affect the accuracy of ThinPrep cytology test and cervical biopsy results; thus, hysteroscopic resection of cervical canal tissue is recommended as a supplement to cervical biopsy because it helps define the lesion site and may yield a pathologic diagnosis.
