Clinical analysis of forty-one multicentric lesions of female lower genital tract

Objectives: To observe the clinical characteristics of multicentric lesions of lower genital tract. Materials and Methods: A retrospective review of 41 multicentric dysplasia treated in the present hospital from January 2000 to July 2015 was conducted. Multicentric lesions included two or three lesions of cervical intraepithelial neoplasia (CIN), vaginal intraepithelial neoplasia (VAIN), and vulvar intraepithelial neoplasia (VIN). Results: Forty-one patients presented multicentric lesions out of 2,238 patients referred for CIN (1.8%). The average age was 53.6 years. The average number of pregnancies was two (range, one to four). Immunologic disorders were presented in 15/41 (36.6%) patients and 92.7% (38/41) patients had cervico-vaginal or had cervico-vulvar lesions, and one had vaginal and vulvar lesions. Only 4.9% (2/41) had three sites of genital lesions at the same time. 77.5% (31/40) of CIN were high grade (CIN III or microinvasive lesion or carcinamoa in situ), 70.97% (22/31) of VAIN were high grade (VAIN III), and 84.6% (11/13) of VIN were high grade (VIN III). Therapeutic modalities included surgery (conization, vagina lesions resection. hysterectomy, vulvectomy) and non-surgical procedures (cervical fulgurize, intracavitary brachytherapy, and 5-fluorouracil local application). Thirty-eight patients were followed-up and had at least one post-treatment cytological control; 15.8% (6/38) had residual disease. Out of the 38 patients followed-up for more than three months, 32 patients had at least two negative controls after treatment (84.2%) and five of them had recurrence. Conclusion: Multicentric lesions of female lower genital tract are associated with HPV infection, and the lesions are always multicentric and locally multipoint. Appropriate treatments could reduce the rate of residual lesion and recurrence.