%0 Journal Article
%T Fatal invasive cervical cancer secondary to untreated cervical dysplasia: a case report
%A Stephan Braun
%A Daniel Reimer
%A Isolde Strobl
%A Ulrike Wieland
%A Petra Wiesbauer
%A Elisabeth M¨šller-Holzner
%A Siegfried Fessler
%A Arthur Scherer
%A Christian Marth
%A Alain G Zeimet
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-316
%X 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.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.Cases of intra-epithelial disease of the cervix are almost entirely attributable to human papillomavirus (HPV) infection. A minority of women exposed to HPV develop a persistent infection that affects the squamocolumnar junction where the ectocervix and endocervix meet. Within that junction, dynamic changes of the epithelium occur due to puberty, pregnancy, menopause and hormonal stimulation. The epithelium is vulnerable to noxae associated with smoking, contraceptive use and infection with other sexually transmitted diseases. Alterations of the epithelium are assessed by conventional cervical cytology screening and are scored according to either the Bethesda or the Papanicolaou system. The occurrence of reactive changes and/or cell abnormalities triggers either repetitions of the cytology screening to exclude temporary alterations or a cervical biopsy for histological diagnosis of cervical intra-epithelial neoplasia and cervical cancer. With the advent of HPV vaccination [1] and HPV screening [2] to identify women at risk of lesions with atypical or malignant cells prior to clinical manifestation, in current clinical practice a patient's HPV status should play a central role in
%U http://www.jmedicalcasereports.com/content/5/1/316