Definition of precursors in gynecologic cancer


  • Robert E. Scully MD

    Corresponding author
    1. Department of Pathology, Harvard Medical School and the James Homer Wright Pathology Laboratories, Massachusetts General Hispital, Boston, Massachusetts
    • Department of Pathology, Massachusetts General Hospital, Boston, MA 02114
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    • Professor of Pathology, Harvard Medical School.


Epithelial lesions of the vulva with patterns of dysplasia or carcinoma in situ may be associated with underlying invasive squamous cell carcinoma or the presence of dysplasia or carcinoma elsewhere on the vulva. These lesions may regress spontaneously, particularly when they appear as multiple papules in young patients. Two major classifications of precancerous lesions of the cervix are in current usage: 1) mild to severe dysplasia and carcinoma in situ; 2) cervical intraepithelial neoplasia, grades I to III. Both of them imply a more complete understanding of the nature of these changes than exists at the present time. Precancerous lesions of the cervix, vagina, vulva, and/or perineum are often associated synchronously or asynchronously. Although there are numerous designations for precancerous lesions of the endometrium, relatively little precise information exists about their significance. In managing women with these lesions, the gynecologist should communicate with the pathologist about the meaning of his diagnostic term, inquiring how far along the road toward invasive carcinoma the precancerous process is judged to be.