title: Carcinoma in episiotomy scars.
abstract: The finding of primary or metastatic carcinoma in an episiotomy scar is a rare event; we report three cases. The first patient presented with an abnormal cervical smear and was found to have a primary squamous cell carcinoma of the vulva in an old, healed episiotomy scar. A second patient, diagnosed as having cervical carcinoma 6 months postpartum, was found to have a metastatic deposit in the episiotomy scar during the staging of her disease. The third patient developed adenocarcinoma metastatic from an endocervical primary in an episiotomy scar that presented as a small nodule at the introitus. These cases exemplify the need for careful inspection and biopsy of any nodular lesions in episiotomy scars as part of the initial assessment and follow-up of patients with premalignant or malignant lesions of the lower genital tract.
authors.affiliation: Department of Gynaecology, St. Bartholomew's Hospital, London, England.
authors.forename: P A
authors.initials: PA
authors.lastname: Van Dam
authors.forename: L
authors.initials: L
authors.lastname: Irvine
authors.forename: D G
authors.initials: DG
authors.lastname: Lowe
authors.forename: C
authors.initials: C
authors.lastname: Fisher
authors.forename: D P
authors.initials: DP
authors.lastname: Barton
authors.forename: J H
authors.initials: JH
authors.lastname: Shepherd
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002921:Cicatrix; D004841:Episiotomy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery