Cervical intraepithelial neoplasia grade 3 in a HPV-vaccinated patient : a case report

Sladič, Mateja (author), Taneska, Pepita (author), Cvjetičanin, Branko (author), Velikonja, Mojca (author), Smrkolj, Vladimir (author), Smrkolj, Špela (author)

Persistent infection with human papillomavirus (HPV) causes almost all cervical precancerous lesions and cancers. Bivalent, quadrivalent, and nonavalent HPV vaccines effectively prevent high-grade cervical intraepithelial neoplasia (CIN3). The effectiveness of HPV vaccination against CIN3 is 97–100% in HPV-naïve populations and 44–61% in the overall population. Although HPV vaccination has substantially reduced the incidence of cervical cancers, several cases of precancerous cervical lesions in HPV-vaccinated patients have been reported. We report the clinical case of a 19-year-old woman whose first Pap smear was diagnosed as a high-grade squamous intraepithelial lesion (HSIL) after quadrivalent HPV vaccination. Colposcopy and cervical biopsy were performed, revealing HSIL/CIN3. Our multidisciplinary team decided to take a conservative approach with follow-up visits with cervical biopsies of this young patient. After six months, spontaneous regression of high-grade cervical dysplasia was observed. Although HPV immunization has shown to be extremely effective in preventing a high proportion of cervical precancerous lesions and cervical cancers, HPV vaccines do not protect against all oncogenic high-risk HPV genotypes. Consequently, healthcare providers must encourage HPV-vaccinated women to still regularly attend national cervical screening programs.

• Language: English
• Keywords: papillomavirus vaccines, Papanicolaou test, cervical intraepithelial neoplasia
• Work type: Article
• Typology: 1.03 - Short Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2022
• Number of pages: 7 str.
• Numbering: Vol. 58, iss. 3, art. 339
• PID: 20.500.12556/RUL-137257
• UDC: 618.1
• ISSN on article: 1648-9144
• DOI: 10.3390/medicina58030339
• COBISS.SI-ID: 98924803
• Publication date in RUL: 08.06.2022

Record is a part of a journal

• Title: Medicina
• Publisher: MDPI
• ISSN: 1648-9144
• COBISS.SI-ID: 6754623

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
• Licensing start date: 01.03.2022

Secondary language

• Language: Slovenian
• Keywords: cepljenje proti papilomavirusu, maternični vrat, rak materničnega vratu, intraepitelna neoplazija, ginekologija