title: Fatal invasive cervical cancer secondary to untreated cervical dysplasia: a case report.
abstract: BACKGROUND
  Well-documented cases of untreated cervical intra-epithelial dysplasia resulting in fatal progression of invasive cervical cancer are scarce because of a long pre-invasive state, the availability of cervical cytology screening programs, and the efficacy of the treatment of both pre-invasive and early-stage invasive lesions.
  
  
  METHODS
  We present a well-documented case of a 29-year-old Caucasian woman who was found, through routine conventional cervical cytology screening, to have pathologic Papanicolaou (Pap) grade III D lesions (squamous cell abnormalities). She subsequently died as a result of human papillomavirus type 18-associated cervical cancer after she refused all recommended curative therapeutic procedures over a period of 13 years.
  
  
  CONCLUSIONS
  This case clearly demonstrates a caveat against the promotion and use of complementary alternative medicine as pseudo-immunologic approaches outside evidence-based medicine paths. It also demonstrates the impact of the individualized demands in diagnosis, treatment and palliative care of patients with advanced cancer express their will to refuse evidence-based treatment recommendations.
authors.affiliation: Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstrasse 35, AT-6020 Innsbruck, Austria. alain.zeimet@i-med.ac.at.
authors.forename: Stephan
authors.initials: S
authors.lastname: Braun
authors.forename: Daniel
authors.initials: D
authors.lastname: Reimer
authors.forename: Isolde
authors.initials: I
authors.lastname: Strobl
authors.forename: Ulrike
authors.initials: U
authors.lastname: Wieland
authors.forename: Petra
authors.initials: P
authors.lastname: Wiesbauer
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Müller-Holzner
authors.forename: Siegfried
authors.initials: S
authors.lastname: Fessler
authors.forename: Arthur
authors.initials: A
authors.lastname: Scherer
authors.forename: Christian
authors.initials: C
authors.lastname: Marth
authors.forename: Alain G
authors.initials: AG
authors.lastname: Zeimet