Obstetrics & Gynecology>>>>>Benign and Malignant Disorders of the Breast and Pelvis
Question 8#

A 45-year-old G1P1 presents for her routine annual examination. The patient is a healthy smoker who has no medical problems. Her surgical history is significant for a cesarean delivery with bilateral tubal interruption. You perform a Pap smear, which returns showing high grade squamous intraepithelial lesion (HSIL). She undergoes colposcopy, which is inadequate.  

This patient now asks you for your advice on how to treat her cervical cancer.

Your best recommendation is for the patient to undergo which of the following?

A. Treatment with external beam radiation
B. Implantation of radioactive cesium into the cervical canal
C. Extrafascial hysterectomy
D. Radical hysterectomy with pelvic lymphadenectomy
E. Treatment with adjuvant chemoradiation

Correct Answer is C

Comment:

The treatment of choice for microinvasive disease in a woman who has completed childbearing is extrafascial (or simple) hysterectomy. If the patient desired fertility sparing treatment, then stage Ia1 disease may be treated with cone biopsy.