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发帖数: 496 | 1 Female, 36y, no family hx of CRC or gyn cancers.
Personal hx of rectal cancer stage 1 pT1N0M0 s/p LAR w/TME in Dec 12, NED as
of Jun 13.
6mo hx of pelvic pain & diffuse abd pain, nausea, bloating, indigestion,
fatigue, weight loss. Acute onsite of LUQ pain radiating to back & McBurney
tenderness 3 wks ago, radiologists differ in opinion (omental infarct vs.
peploic appendagitis), not sure related to acute sx, both recommend
conservative tx. Pain still not resolving, currently managed w/ Ultram ER
100mg daily. Abd/pelvis MRI pending.
8mo hx of intermittent vaginal spotting (predates surgery), 2mo hx of
menstrual clotting, uterine tenderness, painful intercourse. TVUS normal
uterus, ovary, 1.6cm endo stripe. Pap smear normal in Feb 12, CIN1 & hrHPV
positive in Jun 13. Normal colposcopy. ECC/EMB pending. Gyn recommends
hysterectomy due to cancer hx at young age, CIN + hrHPV infx, and unspecific
severe pelvic pain.
Pt is TTC and referred to REI ready for IUI. Colonoscopy scheduled prior to
IUI.
Questions -
(1) Assuming normal colonoscopy, benign ECC/EMB, is it safe to conceive? GI
doc said not recommended till cause of pain dx'd or pain resolves; gyn &
PCP said TTC ASAP while still CIN1.
(2) Is it common to see progression from neg to CIN1 in ~1yr? Will it likely
progress to >CIN3 during pregnancy in 1yr?
(3) Pls share your thoughts how to manage this case. How risky is pregnancy
in this case?
Thank you! |
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