• Please Note: Cases of the Month has been temporarily suspended as we work on the new ASCCP Risk-Based Management Consensus Guidelines, which will be published in 2020. Check back in early 2020 for new cases, which will serve as a resource and learning tool for the implementation of the new Guidelines.

    Each month, ASCCP releases a new case review that will allow you to test your knowledge in anogenital and HPV-related diseases.

    This resource is available exclusively to ASCCP Members. Not a Member?

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  • Apr 22, 2019
    The patient is a 26 year-old G2P2002 who is having regular periods and has never used contraception. She was sexually abused from ages 6 to 12 years, and has been having consensual sex since age 14. She had cervical cancer screening at age 16 when she was pregnant; cytology was negative. Her second pregnancy was at age 18. She was again screened and cytology was negative...
    Mar 27, 2019
    A 21 year-old G1P0010 presents for a gynecologic exam and her first cervical cancer screening. The patient has no current complaints including abnormal vaginal bleeding. She reports 3 sexual partners in the last 6 months and denies use of contraception. She has a BMI of 19.1. The gynecologic exam is normal except for a scant yellow-white cervical discharge. Cervical cytology and STD testing are obtained. STD testing is positive for chlamydia...
    Feb 04, 2019
    A 35 year-old G2P2002 presents for a routine gynecologic exam. She reports no routine gynecologic care in the last several years. She is uncertain of the date of her last menstrual period and has been sexually active without using contraception. As a part of her care, cervical cancer screening is performed. Cytology returns as high grade squamous intraepithelial lesion (HSIL).
    Oct 15, 2018
    A 56 year-old postmenopausal woman presents to your office with several months of vulvar itching. Her medical history is complicated by obesity, chronic renal insufficiency and diabetes. She has had a renal transplant and is immunosuppressed. The patient has a history of tobacco use and abnormal cervical cancer screening.
    Jul 23, 2018
    A 29- year-old G0P0000 presents for evaluation of her first cervical cancer screening which revealed high-risk HPV (non-16/18) and atypical squamous cells of undetermined significance (ASC-US). She is using Depo-Provera for contraception. She has recently undergone evaluation for amenorrhea and galactorrhea which revealed a 7-8 mm pituitary microadenoma accompanied by mildly elevated prolactin levels...
    Mar 08, 2018
    A 21 year-old G0P0 presents to your office for her first gynecologic examination. She has no symptoms or complaints and does not report chronic medical conditions. She does not smoke or use illicit drugs. She has had two male sexual partners in her lifetime and has been using combination oral contraceptive pills for the past 14 months. She has completed her HPV immunization series.
    Feb 16, 2018
    A 47 year- old G5P5005 premenopausal woman presents with persistent abnormal uterine bleeding. She is scheduled for a D&C and ECC in the OR. She did not undergo office endometrial sampling prior to the OR procedures. The uterine histology revealed weakly proliferative endometrium and the ECC demonstrated at least endocervical adenocarcinoma in situ (AIS).
    Jan 02, 2018
    A 54 yo G0P0 presents to your office to establish care because of an insurance change. She received care from her former gynecologist for the past 15 years. She received annual cervical cancer screening showing no history of cervical abnormalities or gynecologic procedures. She has never had an HPV test. Today, she expects her “annual exam” including a PAP test. PMH is notable for hypertension and Cushing Disease dependent on ACTH...
    Oct 26, 2017
    A 23-year-old GO presents for an infertility evaluation. Cervical cancer screening is performed, as she has not been screened previously. Cytology is performed, and her result returns ASC-US. The reflex HPV test is positive for high risk types. Cotesting in 12 months shows HPV-positive HSIL. She is referred for colposcopy. Her colposcopy is shown after application of 3-5% acetic acid.
    Oct 03, 2017
    A 32-year old G4P4 presents with a cervical cytology result of HSIL. HPV testing was not performed. She has had regular cervical cancer screening and denies history of any abnormalities. Patient was referred for colposcopy. There were no atypical vessels on green filter examination. Colposcopy was performed after application of 3-5% acetic acid.

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