A 30-year-old woman is referred after a colposcopy-directed biopsy confirms CIN 3 (high-grade squamous intraepithelial lesion). She is nulliparous and wishes to preserve fertility. The MOST appropriate treatment is:

• A Large loop excision of the transformation zone (LLETZ/LEEP) ✓
• B Simple hysterectomy
• C Cryotherapy
• D Radical hysterectomy

Explanation

LLETZ (large loop excision of the transformation zone), also called LEEP in North America, is the treatment of choice for CIN 2/3. It provides an excisional specimen for pathological assessment to ensure clear margins and rule out micro-invasive disease. Cryotherapy is less appropriate for CIN 3 as it does not provide a histological specimen. Hysterectomy is reserved for recurrent/persistent CIN 3 after excisional therapy or for women who have completed childbearing.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.