Malignant: Cervix

Question 1

Sarcoma botryoides

Answer 1

Embryonal rhabdomyosarcoma

Rare, during adolescence and early adulthood
Polypoid, grape-like mass protruding from vagina

May be deceptively bland; has cambium layer (denser beneath surface)

DDx: sarcoma botryoides of the vagina (identical; but more aggressive and usually in children < 5 years old)

Question 2

Which HPV strain is most commonly implicated in AIS and endocervical adenocarcinoma?

Answer 2

HPV 18; but HPV 16 is becoming more common

Question 3

Invasive squamous cell carcinoma

Answer 3

Precursor lesion: CIN

Patient’s with intraepithelial squamous lesions of any site of the female genital tract, especially women who are immunocompromised, are at increased risk for developing intraepithelial neoplasia of other sites

Question 4

Most common HPV strain?

Answer 4

HPV 16

Most common in both invasive and precursor lesions

50-70% of invasive cervical cancer

Question 5

How many woman with normal cervical cytology will test positive for HPV DNA?

Answer 5

10%

Question 6

Infection with HPV persists in how many?

Answer 6

10-20%; most patients clear it spontaneously

Question 7

General on HPV

Answer 7

double stranded DNA virus

specific only for humans

Tissue-tropic: can complete infectious cycle only in fully differentiating squamous epithelium