title: Endocervical Carcinogenesis and HPV Vaccination: An Occasional Circumstance or a Gap in the Chain?
abstract: As a result of the Human Papillomavirus (HPV) vaccination program, the prevalence of precancerous dysplasia and invasive cervical cancer has substantially decreased. In this brief report, we present a case of a young patient who was diagnosed with in situ adenocarcinoma of the cervix. This 30-year-old female had completed the HPV vaccination after she became sexually active and has been undergoing annual gynecological assessments, including clinical examination and Pap test, all of which had been negative. This year, her Pap test revealed a low grade squamous intraepithelial lesion (LGSIL) and additionally a colposcopy was performed. Given the extent of the lesion and since the colposcopy was inadequate, the patient underwent a type 3 large loop excision of the transformation zone and a curettage of the endocervix under local anesthesia. The pathological diagnosis from cervical biopsy revealed an in situ adenocarcinoma of the endocervix with negative limits. The HPV subtypes 16 and 83 were detected with PCR. After proper consultation she decided to preserve her fertility and to undergo a regular follow-up, postponing hysterectomy after the completion of her family planning. In conclusion, this case report highlights the need for diagnostic surveillance regarding HPV-related cervical cancer even after vaccination.
authors.affiliation: Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Chaidari, 12462 Athens, Greece.
authors.forename: Georgios-Marios
authors.identifier: 0000-0001-8945-4874
authors.initials: GM
authors.lastname: Makris
authors.affiliation: Department of Cytopathology, "ATTIKON" University Hospital, University of Athens Medical School, 1 Rimini, Chaidari, 12462 Athens, Greece.
authors.forename: Petros
authors.identifier: 0000-0002-2957-6850
authors.initials: P
authors.lastname: Karakitsos
authors.affiliation: Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Chaidari, 12462 Athens, Greece.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Kotsifa
authors.affiliation: Department of Cytopathology, "ATTIKON" University Hospital, University of Athens Medical School, 1 Rimini, Chaidari, 12462 Athens, Greece.
authors.forename: Niki
authors.initials: N
authors.lastname: Margari
authors.affiliation: Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Chaidari, 12462 Athens, Greece.
authors.forename: Nikiforita
authors.initials: N
authors.lastname: Poulakaki
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, M. Asias 75, 11527 Athens, Greece.
authors.forename: Theodoros N
authors.identifier: 0000-0002-9355-5528
authors.initials: TN
authors.lastname: Sergentanis
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital of Mainz, University of Mainz Medical School, 55131 Mainz, Germany.
authors.forename: Marco-Johannes
authors.initials: MJ
authors.lastname: Battista
authors.affiliation: Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Chaidari, 12462 Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Chrelias
authors.affiliation: Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Chaidari, 12462 Athens, Greece.
authors.forename: Nicolaos
authors.initials: N
authors.lastname: Papantoniou