title: The implantation of cervical neoplasia at postpartum episiotomy scar: the clinical evidence.
abstract: BACKGROUND
  Cervical cancer recurrence in episiotomy scars after vaginal deliveries is a rather rare event.
  
  
  OBJECTIVE
  We present a review of the current literature data on the field.
  
  
  METHODS
  A systematic search was performed in PubMed and Scopus.
  
  
  RESULTS
  10 case reports and 3 case series with total 18 patients were included. The mean age of the patients was 33.3 years. One of them was diagnosed 1 year before her pregnancy, two of them were diagnosed during pregnancy, six of them during labor and eight patients at postpartum follow-up appointments from 1 week to 8 months postpartum. Twelve cases were squamous cell carcinoma, five cases adenocarcinoma and one case adenosquamous carcinoma with the majority of them staged as Ib1-2. The interval time from initial diagnosis to detection of recurrence had a wide range from 5 weeks to 5.5 years. The diameter of the recurrence was also ranging (5-60 mm). The management of such a recurrence included different extent of wide local excision or chemotherapy or radiotherapy or combinations of them.
  
  
  CONCLUSIONS
  Clinicians should be aware about the importance of carefully examining not only the cervix at the time of labor, but also the episiotomy scar in women following a pregnancy complicated by cervical cancer.
authors.affiliation: IASO Maternity Hospital, 38 Seizani Str., Nea Ionia, 14231, Athens, Greece, christosiavazzo@hotmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Iavazzo
authors.forename: C
authors.initials: C
authors.lastname: Karachalios
authors.forename: P E
authors.initials: PE
authors.lastname: Iavazzo
authors.forename: I D
authors.initials: ID
authors.lastname: Gkegkes
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery; D018196:Carcinoma, Adenosquamous / Q000556:secondary / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery; D002921:Cicatrix / Q000150:complications*; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009366:Neoplasm Seeding; D010502:Perineum; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery