A 68-year-old woman has a large, warty, cauliflower-like growth on the cervix. Biopsy shows marked papillomatosis, acanthosis and koilocytosis with broad pushing borders and no true stromal invasion. The preferred treatment is:

• A Definitive external beam radiotherapy with brachytherapy
• B Radical excisional surgery ✓
• C Topical imiquimod
• D Neoadjuvant chemotherapy followed by surgery

Explanation

This is verrucous carcinoma of the cervix, a well-differentiated variant of squamous cell carcinoma that spreads by pushing rather than infiltrating margins and rarely metastasizes. Radical surgical excision is the treatment of choice because radiotherapy is contraindicated: irradiation may induce anaplastic transformation into a highly aggressive carcinoma. Imiquimod is inadequate for an invasive malignant lesion of this size.

Reference: Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.