A 30-year-old nulliparous woman has CIN 3 on colposcopy-directed biopsy. She strongly desires future fertility. The preferred management is:
- A Large loop excision of the transformation zone (LLETZ/LEEP) ✓
- B Simple hysterectomy
- C Radical trachelectomy
- D Cryotherapy
Correct answer: A. Large loop excision of the transformation zone (LLETZ/LEEP)
Explanation
CIN 3 is a high-grade precancerous lesion, not invasive carcinoma. LLETZ (large loop excision of transformation zone), also called LEEP, is the treatment of choice: it is excisional (provides histology of margins), fertility-preserving, and has high cure rates > 90% for CIN 3. Radical trachelectomy is reserved for early invasive cervical carcinoma (Stage IA2–IB1) in fertility-preservation candidates. Simple hysterectomy is definitive for CIN 3 but sacrifices fertility. Cryotherapy is ablative and not preferred for CIN 3 due to inability to assess margins.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.